After exercise is ceased, the pressure in the compartment will decrease within a few minutes, relieving painful symptoms. These symptoms are brought on by exercise and consist of a sensation of extreme tightness in the affected muscles followed by a painful burning sensation if exercise is continued. Moderate weakness in the affected region can also be observed. This pain can occur for months, and in some cases over a period of years, and may be relieved by rest. The symptoms of chronic exertional compartment syndrome, CECS, may involve pain, tightness, cramps, weakness, and diminished sensation. Pallor can also result from arterial occlusion. Absent pulses only occur when there is arterial injury or during the late stages of the compartment syndrome, when compartment pressures are very high. Pallor and pulselessness – A lack of pulse rarely occurs in patients, as pressures that cause compartment syndrome are often well below arterial pressures.It may indicate both a nerve or muscular lesion. Paralysis – Paralysis of the limb is a rare, late finding.This may progress to loss of sensation ( anesthesia) if no intervention is made. Paresthesia (altered sensation) – A person may complain of "pins & needles", numbness, and a tingling sensation.The role of local anesthesia in delaying the diagnosis of compartment syndrome is still being debated. However, such pain may disappear in the late stages of the compartment syndrome. The pain is aggravated by passively stretching the muscle group within the compartment. This pain may not be relieved by strong analgesic medications. Pain – A person may experience pain disproportionate to the findings of the physical examination.Pain and paresthesia are the early symptoms of compartment syndrome. There are five characteristic signs and symptoms related to acute compartment syndrome: pain, paraesthesia (reduced sensation), paralysis, pallor, and pulselessness. Acute Acute compartment syndrome with blister formation in the arm of a child In chronic exertional compartment syndrome the pain will dissipate with rest. In acute compartment syndrome, the pain will not be relieved with rest. Range of motion may be limited while the compartment pressure is high. Usually, the pain cannot be relieved by NSAIDs. There may also be decrease pulses in the limb along with associated paresthesia. The limb affected by compartment syndrome is often associated with a firm, wooden feeling or a deep palpation, and is usually described as feeling tight. Signs and symptoms Ĭompartment syndrome usually presents within a few hours of an inciting event, but may present anytime up to 48 hours after. Untreated, acute compartment syndrome can result in Volkmann's contracture. Compartment syndrome was first described in 1881 by German surgeon Richard von Volkmann. The condition occurs more often in males and people under the age of 35, in line with the occurrence of trauma. Rates in other areas of the body and for chronic cases are unknown. Īcute compartment syndrome occurs in about 3% of those who have a midshaft fracture of the forearm. Treatment may include physical therapy or-if that is not effective-surgery. Other conditions that may present similarly include stress fractures and tendinitis. Generally, this condition does not result in permanent damage. Common activities that trigger chronic compartment syndrome include running and biking. In chronic compartment syndrome (aka chronic exertional compartment syndrome), there is generally pain with exercise but the pain dissipates once activity ceases. If not treated within six hours, permanent muscle or nerve damage can result. Treatment is by surgery to open the compartment, completed in a timely manner. Normal compartment pressure should be within 12-18 mmHg anything greater than that is considered abnormal and would need treatment. Diagnosis is generally based upon a person's symptoms and may be supported by measurement of intracompartmental pressure before, during, and after activity. It can also occur after blood flow returns following a period of poor blood flow. It is most commonly due to physical trauma such as a bone fracture (up to 75% of cases) or crush injury, but it can also be caused by acute exertion during sport. Symptoms of acute compartment syndrome (ACS) can include severe pain, poor pulses, decreased ability to move, numbness, or a pale color of the affected limb. Compartments of the leg or arm are most commonly involved. There are two main types: acute and chronic. Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space.
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