The muscles in the limbs are organised into compartments, each with blood vessels and nerves running through them. Compartment syndrome is when swelling within a compartment causes problems with these vessels. The condition can be chronic (coming on slowly) or acute (more sudden). It is more common in the lower leg, but can affect the arm and thigh as well.

Symptoms of Compartment Syndrome

In both chronic and acute cases, symptoms include

• pain in the affected limb
• numbness, weakness, pins and needles
• changes to the colour of the skin
• swelling
• reduced ability to move the limb/ extremity 

When the leg is affected, we can test for compartment syndrome by moving your ankle for you. If you present to your osteopath with symptoms suggestive of CS, we will likely send you straight to hospital. If you have changes in sensation in the leg and suspect CS, you should go to A&E immediately.

Causes of Compartment Syndrome

In all cases, rising pressure within the compartment in the cause of the syndrome. But what leads to that is variable. In acute cases, trauma is the most common cause. Under this umbrella, fractures, crush injuries, and burns are usually involved.

However, chronic cases are harder to explain. The understanding is that it comes down to a combination of factors, such as excessive muscle growth or swelling and microtrauma. For these reasons, endurance athletes can be more predisposed to developing the chronic condition. Marathon runners and people who march for extended periods are more likely to be affected in the leg, whereas rowers are more likely to develop the syndrome in the arm.

Why It’s an Emergency

When the pressure within the compartment rises, it compresses the blood vessels running within. As they compress, blood flow is reduced, limiting the amount of oxygen that can reach the muscles beyond. Given enough time, the muscles will starve and die, requiring surgery. Similarly, if the nerves and their blood supply are compressed, they may be damaged to a point when symptoms of numbness and weakness become permanent. Early diagnosis and action can limit the damage and lead to a more full recovery.

Managing Chronic Compartment Syndrome

Chronic cases can be managed with physical therapy and lifestyle changes. The NHS recommends avoiding aggravating activities and reducing inflammation. It also mentions orthotics for when you return to exercise. Returning to exercise can be daunting, as it’s sometimes tricky to know how much is too much. We can support you here alongside providing the physical therapy mentioned above. Expect treatment to involve techniques that aim to:

• improve circulation
• reduce tension in the affected area
• reduce demand from other areas that might not be working as well as they could

As always, your treatment plan is developed specifically for you, and is an ongoing collaboration with you. If you have specific goals for your treatment, or you would like to avoid specific techniques, just let us know and we can work with that in mind.

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If you have the symptoms of acute compartment syndrome, call 999 or go to A&E