Chronic exertional compartment syndrome is an exercise-induced muscle and nerve condition that causes pain, swelling and sometimes disability in the affected muscles of your legs. Anyone can develop the condition, but it’s more common in athletes who participate in activities that involve repetitive impact, such as running.
The signs and symptoms associated with chronic exertional compartment syndrome might include:
- Aching, burning or cramping pain in the affected limb — usually the lower leg
- Tightness in the affected limb
- Numbness or tingling in the affected limb
- Weakness of the affected limb
- Foot drop, in severe cases, if legs are affected
- Often occurs in the same compartment of both legs
- Occasionally, swelling or bulging as a result of a muscle hernia
Pain due to chronic exertional compartment syndrome typically follows this pattern:
- Begins after a certain time, distance or intensity of exertion after you start exercising the affected limb
- Progressively worsens as you exercise
- Subsides within 10 to 20 minutes of stopping the activity
- Over time, recovery time after exercise often increases
By taking a complete break from exercise or performing only low-impact activity your symptoms may be relieved, but usually only temporarily. For instance, once you take up running again, those familiar symptoms usually come back.
Compartment Pressure Testing
If imaging studies fail to uncover an abnormality such as a stress fracture or similar cause of pain, your doctor might suggest measuring the pressure within your muscle compartments. This test, often called compartment pressure measurement, is the gold standard for diagnosing chronic exertional compartment syndrome. Because it’s invasive and mildly painful, involving insertion of needles into your muscles, compartment pressure measurement usually isn’t performed unless your medical history and other tests strongly suggest you have this condition.
Options to treat chronic exertional compartment syndrome include both non-operative and surgical methods. However, non-operative measures are typically successful only if you stop or greatly reduce the activity that caused the condition.
Your doctor may initially recommend pain medications, stretching or strengthening regimens, orthotics, massage, a break from exercise, or the use of different biomechanical techniques, such as changing how you land when you jog. However, non-operative options typically don’t provide lasting benefit for true chronic exertional compartment syndrome.
Surgery is the most effective treatment of chronic exertional compartment syndrome. Surgery involves operating on the inelastic tissue encasing each muscle compartment (fascia). Methods include either cutting open the fascia of each affected compartment (fasciotomy) or actually removing part of the fascia (fasciectomy). Surgery relieves the pressure. Although surgery is effective for most people, it’s not without risk. Complications of the surgery can include infection, permanent nerve damage, numbness, and scarring.