Compartment Syndrome

Condition

Chronic compartment syndrome is a condition that occurs, commonly in the lower leg, during exercise and results in a build up of pressure within the muscle compartment. This often become severe enough to prevent activity.

What causes?

The exact cause is not well understood. Muscles are surrounded by fascia which is a thin tissue which helps to keep the muscles in place in respect to one another but also helps to guide movement. Muscles tend to be grouped in compartments which are defined by the fascia. If the fascia is tight or the muscles are particularly bulky, this can predispose to increased pressure within the muscle compartment. During exercise, this pressure increases and in some people, the pressure builds to a level that causes pain.

Will it get worse?

Left un-treated, most musculoskeletal problems deteriorate, eventually causing reduced activity. However, with chronic compartment syndrome, the exercise that causes the symptoms can be quite specific. For instance, someone may be able to play tennis for three hours but get symptoms if they run in a straight line for several minutes. Thus, avoiding the activity that causes the symptoms is a reasonable way of managing the problem.

What are the common symptoms?

• Pain gradually increases during activity and will often reach a level that stops the activity.
• Some people can get pins and needles / numbness in the feet but this does not always occur.
• Unlike most muscle or bone injuries, when the activity stops, rather than the symptoms easing off quickly, this will take time for the symptoms to subside.
• Commonly, normal activities can be resumed without symptoms and there will be no significant pain the following day.
• Some patients also have medial tibial stress syndrome and therefore can present with a mixed picture.

How is it recognised?

• Clinical examination and a detailed history allow diagnosis.
• A specific test to measure the pressures within the compartments before and after exercise is required for a firm diagnosis.
• An MRI scan may be necessary to evaluate for other conditions which can exist.

What can I do to reduce the pain?

• Avoid the exercise that causes the symptoms
• See a podiatrist

What will Premier Podiatry do?

If simple measures do not reduce your symptoms, there are other options:

• Confirm the diagnosis / arrange any necessary investigations
• Refer for a surgical opinion.

Will this cure the problem?

Conservative treatment options have not been shown to be effective for this condition. Definitive treatment involves cutting to the fascia to relieve the pressure.

What will happen if I leave this alone?

Nothing, as long as you avoid the exercise that causes the symptoms.