Causative & risk factors
Whenever a muscle is exercised, it’s blood supply increases and the muscle with its connective tissue expands. If this connective tissue fails to expand, pressure starts building up within the exercised muscle. This pressure can lead to reduction of blood supply to the muscle, which leads to chronic exertional compartment syndrome.
The typical patient profile is that of an athlete or a physically active person under the age of 30 years. Taking supplements like creatine or anabolic steroids adds to the risk of developing chronic exertional compartment syndrome.
Clinical presentation
The affected limb is extremely painful, tense and weak. The pain begins soon after the limb is exercised and keeps on worsening throughout the duration of exercise. The pain stops soon after the limb is rested. Numbness or tingling may be present.
Chronic exertional compartment syndrome can lead to complications like muscle hernia or foot drop.
Investigations
The doctor will assess the patient’s history and carry out a physical exam to rule out other conditions.
Imaging studies such as a MRI scan or ‘near infrared spectroscopy ’of the affected limb are performed.
To confirm the diagnosis of chronic exertional compartment syndrome, the ‘compartment pressure measurement’ test is carried out.
Treatment
Chronic exertional compartment syndrome can be treated conservatively as well as surgical methods. Conservative measures are suggested to those who are willing to forgo their exercise or athletic activity completely. Surgery is suggested to those who wish to maintain their levels of activity.
Conservative treatment includes massages, applying biomechanical techniques, pain-relieving drugs and physical therapy.
Surgery is the primary treatment of chronic exertional compartment syndrome. The affected fascia is either cut off (fasciotomy) or removed (fasciectomy).
