Compartment Syndrome - Symptoms

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What are the symptoms and signs of compartment syndrome?

The symptoms of compartment syndrome, plus the circumstances that led to their development assist to make the clinical diagnosis. Pain out of proportion to the injury (or physical examination of the muscle compartment) often is the clue to make the diagnosis of compartment syndrome. Increased pressure within the muscle compartment causes loss of blood supply and nerve inflammation. This causes significant pain and numbness or paresthesia. (para=abnormal + ethesia=feeling).

The diagnosis should be always considered when there is either an associated fracture, high velocity injury like a gunshot wound or a crush injury. Individuals who are taking anticoagulant medications such as warfarin (Coumadin) or enoxaparin (Lovenox) are at higher risk for bleeding into a compartment spontaneously or after injury.

Historically, the mnemonic memory device for compartment syndrome is the "5 Ps" (pain, paresthesia [change in sensation], pallor [pale coloration], paralysis, and poikilothermia [inability to control temperature]; some authors include pulselessness), but this should not be relied upon to make a diagnosis. Only pain and change in sensation (parathesia) may be symptoms that point to the diagnosis of a developing compartment syndrome.

Examination of the extremity often reveals tense and shiny skin that may be significantly bruised. Pain occurs with minimal range of motion of the foot, hand, or any of the extremity with compartment syndrome. The patient may have difficulty moving the extremity without assistance and pain is provoked when the care practitioner takes the affected limb though any range of motion

In chronic compartment syndrome, there may be pain with range of motion of the extremity and muscle bulging may be noticed. Numbness is common but all symptoms usually resolve within a few minutes of discontinuing exercise.

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Comment from: 65-74 Male (Patient) Published: December 13

With my compartment syndrome I had extreme leg swelling, excruciating pain, and inability to put weight on the leg.

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