Compartment Syndrome

Diagnosis of Compartment Syndrome

Initial Consultation: The doctor will enquire about the injury and symptoms to understand the risks and determine the condition.

Physical Exam: A physical exam is conducted to diagnose compartment syndrome.

Measurement of Pressures: A definite compartment syndrome diagnosis needs appropriate pressure measurement. The doctor inserts a needle into the area where compartment syndrome is suspected while the pressure is recorded. The doctor may also insert a plastic catheter to monitor the compartment pressure. A pressure monitor may also be inserted into the bladder through a urinary catheter. It helps to measure high pressures in the bladder during the diagnosis. Additionally, laboratory and imaging tests may be suggested to diagnose compartment syndrome.

Treatment for Compartment Syndrome

Treatment for compartment syndrome is aimed at minimizing pressure in the body compartment. Patients with acute compartment syndrome need immediate surgery to reduce the compartment pressure. Long incisions are made through the skin and fascia layer underneath to release excessive pressure.

A doctor may suggest supportive treatments such as:

• Keeping the affected body part below the level of the heart (this helps improve blood flow into the compartment)
• Supplying oxygen through the nose or mouth
• Supply of fluids intravenously
• Pain-relieving medications

Chronic Compartment Syndrome: Patients are suggested to avoid the activity that caused it in the first place. A doctor will suggest stretching and physical therapy exercises. Surgery may be required in the long run to relieve pressure.

Abdominal Compartment Syndrome: The treatment for this condition includes life support measures such as mechanical ventilation and medicines to manage blood pressure. Kidney replacement therapies are also suggested. Surgery is also suggested to open the abdomen to reduce compartment syndrome pressures.

Recovery

Recovery from compartment syndrome aims to rebuild strength and flexibility in the affected muscles. Patients are also suggested to modify activities to prevent the condition from recurring. Doctors may recommend their patients to physical therapists who can help them feel better and return to normal life in the least possible time.

Physical Therapy: It is an integral part of recovery, especially after surgery for compartment syndrome. The doctor will suggest physical therapy after the incision has healed completely. The therapists will customize an exercise routine to rebuild strength, flexibility, and range of motion in the leg or arm.

Physical therapy during the first few weeks is focused on adding strength to muscles and stretching them without putting any weight on the affected limb. Any postoperative swelling and pain can be reduced by applying ice or heat to the muscles. Anti-inflammatory medications may also be prescribed to reduce swelling and pain.

Gradually, the doctor will suggest you start weight-bearing exercises to strengthen muscles and increase your range of motion. Once you can do weight-bearing exercises without pain in the affected limb, the doctor may suggest you incorporate high-impact activity into your daily exercise routine. Complete recovery from the condition may take 3-4 months.

Activity Modification: Compartment Syndrome in the lower leg needs modification of activity and plan, especially for sports personalities, athletes, and gym goers who wish to return to running or any other high-impact sport to prevent the condition from recurring. Appropriate footwear is necessary when exercising. It is advised to wear shoes with ample arch support and a cushioned sole.

Running on rigid surfaces should be avoided as it can lead to recurring symptoms. The best option is a grass or track surface. It does not put pressure on leg muscles.

• Symptoms and Causes