Dominic Stone
In anatomy, a compartment is a group of muscles, nerves, and blood vessels covered by a thin, firm membrane called a fascia. Compartments can be found in the arms, legs, abdomen, and buttocks. Compartment syndrome is a painful condition that occurs when there is a dangerous buildup of pressure in the muscles, causing symptoms such as severe pain, swelling, and tingling. This can lead to permanent muscle damage if left untreated.
| Characteristics | Values |
|---|---|
| Definition | A "compartment" is the medical term for a group of muscles, nerves and blood vessels. |
| Covering | Covered by a fascia — a thin, firm membrane. |
| Compartment Syndrome | Compartment syndrome happens when extra pressure builds up inside a compartment and muscles press against the fascia. |
| Compartment Syndrome Causes | Severe injuries, intense physical activities or exercise, athletic exertion, crush injuries, anabolic steroid use, constricting bandages, blocked circulation, etc. |
| Compartment Syndrome Symptoms | Visible bulging or swelling, muscle pain, severe pain when stretching, tingling or a burning feeling under the skin, feeling of fullness in the muscle, etc. |
| Compartment Syndrome Treatment | Surgery (fasciotomy) to relieve pressure in the muscle, anti-inflammatory painkillers, changing workout routine, etc. |
| Compartment Syndrome Complications | Permanent muscle damage, paralysis, or death. |
| Compartment Syndrome Occurrence | Legs (especially lower legs), arms, abdomen, buttocks, hands, wrists, feet, thigh, etc. |
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What You'll Learn
Compartment syndrome
A "compartment" is the medical term for a group of muscles, nerves, and blood vessels. Compartments are covered by a fascia, a thin, firm membrane. Compartment syndrome is a painful condition that occurs when there is a buildup of pressure around the muscles, causing them to press against the fascia more than they should. This restricts blood flow, preventing oxygen and nutrients from reaching the muscles and nerves.
The symptoms of compartment syndrome include intense pain, swollen and visibly bulging muscles, severe pain when stretching, and a feeling of fullness or firmness in the muscle. In the case of acute compartment syndrome, the pain is more intense than what would be expected from the injury itself, and it increases with muscle use or stretching.
Treatment for compartment syndrome depends on the type. Acute compartment syndrome requires immediate surgery, known as a fasciotomy, to relieve the pressure in the muscle. Chronic compartment syndrome can often be treated by modifying or discontinuing the activity that caused it, such as switching to a low-impact exercise like cycling. Anti-inflammatory painkillers can also be used to reduce pain and discomfort. If these measures do not improve symptoms, surgery may be considered.
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Fascia membrane
A "compartment" is the medical term for a group of muscles, nerves, and blood vessels. Compartments are covered by a thin, firm membrane called fascia. Fascia is made up of sheets of connective tissue found below the skin. Fasciae are classified as superficial, visceral, or deep, and further designated according to their anatomical location.
Superficial fascia is found directly under the skin and superficial adipose layers. It is thicker in the trunk than in the limbs and becomes thinner peripherally. Superficial fascia layers can sometimes include muscle fibres to create various structures in the body. For example, the platysma muscle in the neck and the external anal sphincter.
Deep fascia surrounds bones, muscles, nerves, and blood vessels. It has a more fibrous consistency and is rich in hyaluronan. Deep fascia tends to be highly vascularized and contains well-developed lymphatic channels. In some instances, deep fascia can even contain free encapsulated nerve endings, such as Ruffini and Pacinian corpuscles.
Visceral fascia (also called subserous fascia) suspends the organs within their cavities and wraps them in layers of connective tissue membranes. Each organ is covered in a double layer of fascia, separated by a thin serous membrane. The outermost wall of the organ is known as the parietal layer, and the skin of the organ is known as the visceral layer.
Compartment syndrome is a painful buildup of pressure around muscles. This can happen when there is an injury or repeated stress that causes swelling and bleeding inside a muscle compartment. The pressure restricts the flow of blood, oxygen, and nutrients to the muscles and nerves. If the pressure keeps building, the fascia runs out of room and starts squeezing against the muscles and nerves, causing pain and other symptoms.
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Acute and chronic conditions
A "compartment" is the medical term for a group of muscles, nerves, and blood vessels. Compartments are covered by a fascia — a thin, firm membrane. Compartment syndrome is a painful buildup of pressure around these muscles. It happens when extra pressure builds up inside a compartment, causing the muscles to press against the fascia more than they should.
Acute compartment syndrome occurs when there is increased pressure within a closed osteofascial compartment, resulting in impaired local circulation. It is a medical emergency that happens suddenly, usually after a severe injury or as a surgery complication. It can also occur without any precipitating trauma but typically occurs after a long bone fracture, with tibial fractures being the most common cause of the condition, followed by distal radius fractures. Seventy-five per cent of cases of acute compartment syndrome are associated with fractures. After fractures, the most common cause is soft tissue injuries. Other causes include car accidents, falling from a high place, crushing injuries, severe muscle contusions, sports injuries, and complications from wearing a cast or splint that's too tight.
Acute compartment syndrome is a surgical emergency since, without prompt treatment, it can lead to ischemia and eventually necrosis. It can cause permanent muscle damage, paralysis, or even death. If you suspect acute compartment syndrome, you must go to the emergency room right away. Treatment for acute compartment syndrome involves surgery as soon as possible to relieve the pressure in the muscle. This surgery is called a fasciotomy, where the surgeon makes cuts around the muscle to relieve the pressure. Skin grafts may also be necessary.
Chronic compartment syndrome, also called chronic exertional compartment syndrome, typically builds up slowly over time after intense or frequent physical activity, exercise, or training. It is not usually an emergency but can be extremely painful. It is a musculoskeletal condition brought on by exercise, where the fascia does not expand with the muscle, causing pressure and pain in a compartment of the affected limb. It can affect any muscle compartment but is most common in the lower legs. It may also be caused by having muscles that enlarge excessively during exercise, an inflexible fascia, or high pressure within the veins.
Chronic compartment syndrome is usually manageable without surgery. Treatment for chronic compartment syndrome involves tweaking your workout routine, switching to low-impact exercises, and using anti-inflammatory painkillers. If symptoms do not improve, surgery may be an option, which can be successful and allow people to return to their sport.
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Symptoms and causes
Compartment syndrome is a painful buildup of pressure around your muscles. It happens when extra pressure builds up inside a "compartment" (a group of muscles, nerves, and blood vessels covered by a thin, firm membrane called fascia) and your muscles press against the fascia more than they should.
Symptoms of Compartment Syndrome
- Visible bulging or swelling around a muscle
- Muscle pain (more severe than the usual soreness after intense activity)
- Severe pain when stretching
- Tingling or a burning feeling under your skin (paresthesia)
- Feeling like your muscle is fuller, firmer, or bigger than usual
- Numbness
- Difficulty moving a body part
Causes of Compartment Syndrome
The cause of chronic exertional compartment syndrome is not completely understood. However, it is believed that when you exercise, your muscles expand in volume, but if you have this condition, the fascia does not expand with the muscle, causing pressure and pain. Other causes might include:
- Having muscles that enlarge excessively during exercise
- Having an especially inflexible fascia surrounding the affected muscle compartment
- Having high pressure within your veins
- Severe injuries, such as car accidents
- Surgery complications
- Bone fractures, especially in the tibia or shin bone
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Treatment
Compartment syndrome is a painful condition where excessive pressure builds up inside a group of muscles, nerves, and blood vessels, known as a muscle compartment. This pressure restricts blood flow, oxygen, and nutrients to the muscles and nerves, which can cause tissue death and organ damage. It is often caused by trauma, such as a car accident or broken bone, and can be a side effect of treatment, such as surgery or casting. It can also be caused by anabolic steroid use or excessive exercise.
For acute compartment syndrome, which occurs suddenly, surgery is often required to relieve the pressure. This procedure is called a fasciotomy, where a surgeon makes long incisions through the skin and the fascia layer to release the pressure. The sooner the fasciotomy is performed, the better the recovery of limb function. After the surgery, patients may require a skin graft to close the incision and will need to rest for a few months before using those muscles again.
Chronic compartment syndrome, which develops gradually, may not require surgery. Treatment options include resting the affected muscles, avoiding activities that cause symptoms, switching to lower-impact exercises, and taking anti-inflammatory medications to reduce inflammation and pain. Physical therapy can also help increase strength and flexibility in the affected muscles and teach modifications to prevent stress and pressure buildup. Orthotics, or shoe inserts, may be recommended for those with compartment syndrome in their legs. If other treatments are ineffective, surgery may be considered.
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Frequently asked questions
A muscle compartment is a group of muscles, nerves, and blood vessels covered by a thin, firm membrane called a fascia.
Compartment syndrome is a painful condition where pressure builds up inside a muscle compartment, causing the muscles to press against the fascia.
Compartment syndrome can be caused by a severe injury, such as a car accident or a broken bone, or by repeated stress and intense physical activity.
Symptoms of compartment syndrome include severe muscle pain, visible bulging or swelling around the muscle, and a tingling or burning feeling under the skin.
Treatment for compartment syndrome depends on the type and severity of symptoms. Acute compartment syndrome requires immediate medical attention and surgery to relieve pressure, while chronic compartment syndrome can often be treated with rest and anti-inflammatory painkillers.
