Compartment Syndrome of the Legs

Compartment syndrome is a condition that most often appears in the front of the lower legs. Compartment syndrome involves the swelling or bleeding in the lower leg compartment, causing pressure on the capillaries, nerves and muscles in that region. This restricts blood flow to the muscle and nerve cells.

This condition can present itself in two very different ways: acute compartment syndrome or chronic compartment syndrome.

Acute compartment syndrome usually occurs after a severe injury, often being caused by a fracture, bruised muscle, or restored blood flow after blocked circulation. Unless pressure is relieved quickly, acute compartment syndrome may lead to disability and tissue death.

Symptoms include pain, especially when the muscle within the affected compartment is stretched. This pain is more intense than what would be expected from the original injury. The muscle may also feel excessively tight. Some may feel burning sensations on the skin. Numbness may occur if the condition is left too long without treatment.

Acute compartment syndrome is an emergency situation involving surgery—there is no nonsurgical treatment that will be effective for this condition. Your doctor will make an incision in the fascia (fasciotomy) to relieve swelling.

Chronic compartment syndrome results from exercise with repetitive motions, such as biking, swimming, or running. Chronic compartment syndrome is usually not dangerous and is relieved by stopping the particular exercise.

While exercise-induced compartment syndrome is not common, it is often misdiagnosed as medial tibial stress syndrome (shin splints) or stress fractures.

Symptoms include pain or cramping during exercise, with that pain lessening when exercise stops. Some may experience numbness, trouble moving the foot, or visible muscle bulging.

Nonsurgical treatment, including physical therapy, orthotics, and anti-inflammatory medications, may be first used to treat this condition. It can also be helpful to avoid the activity that caused chronic compartment syndrome, opting for low-impact activity instead. If conservative efforts do not work, surgery may be used to open the fascia and make more room for muscles to swell. This surgery would be an elective procedure, and not an emergency situation like it is for acute compartment syndrome.