Compartment syndrome is a painful condition, with muscle pressure reaching dangerous levels. Acute compartment syndrome is a medical emergency, usually caused by trauma, like a car accident or broken bone. Chronic (or exertional) compartment syndrome is caused by intense, repetitive exercise and usually stops with rest or changes in routine.
Compartment syndrome occurs when pressure rises in and around muscles. The pressure is painful and can be dangerous. Compartment syndrome can limit the flow of blood, oxygen and nutrients to muscles and nerves. It can cause serious damage and possible death.
Compartment syndrome occurs most often in the lower leg. But it can also impact other parts of the leg, as well as the feet, arms, hands, abdomen (belly) and buttocks.
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There are two kinds of compartment syndrome:
A compartment is a group of muscles, nerves and blood vessels. A thin but firm membrane (covering) called a fascia lies over each compartment. It keeps the muscles in place. But the fascia isn’t meant to stretch or expand much.
A serious injury or too much physical exertion can cause swelling or bleeding in a compartment. The fascia won’t expand to make room, so the swelling or bleeding puts pressure on the nerves and muscles. Healthcare providers call this compartmental pressure.
If the pressure gets too high, the tissues can’t get enough blood, which contains oxygen and nutrients. The tissues can die, leading to permanent damage to the area. These complications can also threaten your life.
Examples of injuries that can cause compartment syndrome include:
Anabolic steroids can also cause compartment syndrome by increasing muscle size too quickly. Other causes include casts or large bandages that are too tight and worn for a while.
Chronic compartment syndrome can happen when a person overtrains (exercises too much). Sports with very repetitive movements pose a particular risk. Examples include:
The symptoms of compartment syndrome can include:
If you think you have acute compartment syndrome, go to an emergency room right away. It’s a medical emergency that needs treatment. If you think you have exertional compartment syndrome, call your healthcare provider.
A healthcare provider will do a few things to diagnose compartment syndrome:
Acute compartment syndrome must get immediate treatment. A surgeon will perform an operation called a fasciotomy. To relieve pressure, the surgeon makes an incision (cut) through the skin and the fascia (compartment cover).
After the swelling and pressure go away, the surgeon will close the incision. Sometimes that can’t happen right away. The surgeon may do a skin graft, taking skin from another area of your body to put over the incision.
Exertional compartment syndrome usually goes away if you stop exercising. But you should still discuss it with your healthcare provider. Your provider may recommend:
If those options don’t work, fasciotomy may be an option.
You can’t prevent acute compartment syndrome caused by an accident or injury. But you can seek early diagnosis and treatment to prevent complications.
If you have a splint or cast that feels too tight, tell your healthcare provider. Pay particular attention if you’ve taken pain medication and that part of your body still hurts or swells. The cast or splint should get adjusted to prevent compartment syndrome.
You can prevent exertional compartment syndrome by:
Acute compartment syndrome needs immediate treatment. If the pressure isn’t relieved quickly, the condition can lead to:
Acute compartment treated with fasciotomy usually doesn’t come back. But chronic compartment syndrome can return if you start intense or repetitive exercise again.
Rest and changes to your exercise routine may help relieve exertional compartment syndrome. But symptoms may come back, especially if you return to intense or repetitive activity.
Call your healthcare provider if pain gets worse over time or does not feel better with rest.
A note from Cleveland Clinic
If you think you have acute compartment syndrome after an injury, seek medical care immediately. Also talk to a healthcare provider if you have unusual pain, swelling or weakness in your muscles that keeps coming back. It may turn out to be tendinitis or shin splints, but you should check to make sure. It could be chronic compartment syndrome. A healthcare provider can suggest strategies to help you feel better and prevent damage to your nerves and muscles.
Last reviewed by a Cleveland Clinic medical professional on 02/15/2021.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy