The body is made up of different muscle compartments, which are like small rooms made of stretchy layers called fascia. Within these compartments lie muscles, nerves, and even the blood vessels that help the body to function well. The pressure within these compartments is typically normal, but in a case where there’s too much pressure build up in one of these compartments, it can lead to a condition known as compartment syndrome. Compartment syndrome stops blood from flowing, which damages the muscles and nerves inside.
What’s Compartment Syndrome?
Compartment Syndrome is a condition that causes pressure to build up inside a group of muscles, which stops oxygen and nutrients from getting to the muscles and nerves. Normally, these muscle compartments have enough space, big enough to accommodate muscles, blood vessels, and nerves in such a way that they work well.
But if there’s an injury (a big bad bruise, broken nose, or swelling from exercise), the compartment can get to tight. The layers covering the muscles (fascia) wouldn’t be able to stretch as it used to, so the pressure keeps increasing. If this goes on for too long, it can damage the muscles and nerves, or even less to a permanent problem.
The Six P’s of Compartment Syndrome
The six P’s are signs the doctors look for to check if someone might have compartment syndrome.
- Pain: A strong pain that wouldn’t go away even after taking medication and resting.
- Paresthesia: A numbness or tingling feeling usually in the arm or leg.
- Pallor: Pale looking skin in the area of pain.
- Pulselessness: No feeling of heartbeat in the wrist or ankle.
- Paralysis: Inability to move the muscles in the area of pain.
- Poikilothermia: The area of pain that feels colder or hotter than the rest of the body.
Causes of Compartment Syndrome
Trauma: Trauma is the most common cause of acute compartment syndrome. It could be injuries like fractures, especially in the legs and forearms, a crush injury, or severe breathing from an accident. If you get injured, this injury causes bleeding or swelling within the muscle compartment. Since the fascia layer around the compartment cannot stretch, the pressure increases and compresses the blood vessels and nerves.
Surgery of Post-Surgical Swelling: Surgeries involving bones or muscles, usually swells or bleeds within the compartment. This added fluid from the swelling increases pressure, which may compromise blood flow and lead to compartment syndrome.
Tight Bandages or Casts: Wrapping a cast, split, or bandage too tight around a limb can cause blood flow to be restricted, which increases pressure in the compartment. The external pressure from the cast or bandage reduces the space available in the compartment, which could lead to little to no blood flow and compression of the nerves.
Burn Injuries: Severe burns can cause the skin and tissue to swell or form a hard crust (eschar) that restricts the compartments below. Swelling from the burn adds to the pressure while the unyielding hard crust acts like a tight band which increases the compartment pressure and reduces circulation.
Vigorous Exercises: Doing repeated intense physical activities, like running for a long distance or lifting weights can cause a serious case of compartment syndrome. That’s because exercise causes the muscles to swell temporarily. In chronic cases, this swelling is repetitive and over time, it increases pressure in the compartment which can lead to one or multiple of the six P’s.
Bleeding Disorder: Some conditions like hemophilia or the use of blood-thinning medications can cause excessive bleeding in a compartment. After even minor injuries, the blood accumulates in the compartment, raising pressure and causing blood circulation.
Infections: Infections such as snake or insect bites or any other severe infection can cause swelling, pus-formation, or tissue damage within a muscle compartment. The buildup of the infected material and swelling increases the pressure. This restricts blood flow and worsens tissue damage over time.
Injection Injuries: There are certain cases where IV fluid or medication accidentally leaks into the tissue instead of the veins. This accident can cause swelling. The leaked fluid builds up in the compartment, which increases pressure and cuts off blood circulation.
Summary
Compartment syndrome happens when pressure builds up inside a muscle group, cutting off blood flow and harming muscles and nerves. It can be caused by things like injuries, tight casts, surgeries, or too much exercise. Symptoms include severe pain, numbness, and pale or cold skin.
