What is compartment syndrome?

Compartment syndrome is a painful condition caused by high pressure in a group of muscles (a muscle compartment).

Compartment syndrome most commonly happens in the legs or forearms. In these areas, there are groups of muscles surrounded by bone and fascia (a tough sheath of tissue with little stretch).

There are 2 types of compartment syndrome:

1. Acute compartment syndrome — usually happens suddenly after an injury. It's extremely painful and needs urgent treatment to prevent permanent damage.
2. Chronic exertional compartment syndrome — can happen with intense, repetitive exercise. It usually gets better with rest.

In acute compartment syndrome, the high pressure can be caused by bleeding or swelling from an injury. Because there is little room for expansion with swelling, the pressure in the muscle compartment rises.

When the pressure reaches a dangerous level, it can reduce or cut off blood flow to the area. This means that oxygen is not able to reach the tissues in the affected area. The muscle tissue may then start to die and break down.

What are the symptoms of compartment syndrome?

Acute compartment syndrome symptoms include:

• intense pain — more painful than you might expect from your injury
• pain that is not controlled with pain-relief medicines
• increased pain and a feeling of tightness when you stretch the affected muscles
• numbness
• paralysis (lack of movement) of the affected area
• pale, cold skin

The affected area may feel firm to touch.

Chronic compartment syndrome symptoms include pain or cramping during exercise that stops once the activity stops.

What causes compartment syndrome?

You can develop acute compartment syndrome after a serious injury such as a:

• bone fracture
• crush injury (for example, from a car accident)
• penetrating injury
• surgery

Other causes can include:

• very tight bandages or casts over an injury
• snake bite or injury from other venomous creatures, such as fish and stingrays
• severe burns
• severe bruising

Your risk of acute compartment syndrome is higher if you have an increased risk of bleeding. This may be due to a condition or medicine you are taking.

Chronic compartment syndromecan be caused by repetitive, intense exercise, such as long-distance running, cycling or rowing.

When should I see my doctor?

If you have symptoms of acute compartment syndrome,call triple zero (000) and ask for an ambulance or go immediately to an emergency department.

See your doctor if you have symptoms of chronic exertional compartment syndrome.

How is compartment syndrome diagnosed?

Your doctor will ask you about your symptoms and any recent injuries. They will examine you and the affected area. They will also check the blood flow in the affected area.

In some acute cases, your doctor may use a device to measure the pressure inside the compartment. They may also recommend blood tests.

How is compartment syndrome treated?

Acute compartment syndrome

If you have acute compartment syndrome, you'll need emergency treatment in hospital. This can include:

• surgery to cut open the skin and fascia to ease the pressure — this is called a 'fasciotomy'
• pain-relief medicines
• fluids given through a drip

Chronic exertional compartment syndrome

If you have chronic exertional compartment syndrome, resting will help ease your symptoms. That is often enough for the condition to settle. Pain-relief medicines can also help.

Your doctor might also advise you to switch to low-impact or a different activity.

Can compartment syndrome be prevented?

After an injury, you should elevate your arm or leg to reduce swelling. If you have a bandage or cast, tell your doctor or nurse if it feels too tight. They may need to adjust it.

If your pain and swelling increase, see a doctor immediately.

Chronic exertional compartment syndrome can be prevented by cutting down or stopping the activity that is causing your symptoms.

Complications of acute compartment syndrome

Acute compartment syndrome is a serious condition that needs emergency treatment. If not treated quickly, the muscle tissue can die.

'Rhabdomyolysis' is when muscle tissue that has died starts to break down. This can lead to acute kidney failure, because the chemicals released from the muscles are toxic to your kidneys.

If treatment is delayed, you may need an amputation.

After having compartment syndrome, some people may have ongoing problems with their affected limb. This may be problems with sensation (such as numbness) or movement.

Resources and support

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.