Excercise induced Compartment syndrome - help with diagnosis

[AnnieDC]

Hi

After 3 years of pain and searching everywhere for a diagnosis I may have compartment syndrome in my lower leg. Currently looking for someone to perform a dynamic pressure monitor to confirm;

Just wondered if anyone could answer these questions?

1. I had been a runner but have given up due to pain. The pain only comes on if I walk or swim using my legs, but not if I cycle or do yoga. Can compartment syndrome be exercise specific and is walking vigorous enough to bring it on?

2. Are there any other conservative treatments? I am really not keen on surgery.

3. I have read the success rate for deep posterior compartment syndrome is as low as 65% does anyone know if this is correct?

Any information or suggestions are very welcome
Thank you,

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Hi Annie DC
I appreciate the research and pain that you have undergone gathering information regarding your problem. Could you answer the following questions please?
1) What is the exact "site" or "location" of pain if you were to refer to a body chart? (please mention current and past episodes)
2) It is not clear from your post, for how long have you had this pain? How many episodes have you experienced and How many days or weeks old is the current episode?
3) Does posture have any relation with your pain? (Does sitting or standing slouched or erect change your leg pain in any way?)
4) Have you ever experienced any low back pain?
5) Is your pain intermittent?
6) What could worsen your pain? Since you have said walking, does the distance or time matter?
7) What effect does bending forwards from your back with your knees straight have on your pain?
8) Is there only pain or is it accompanied by any other sensation such as tingling or numbness?
Please answer these q's so that we can get a clear picture to if your pain is mechanical and can be changed using repeated movement testing. If that works, you may not require surgical intervention.
As for your question regarding compartment syndrome, It can be exercise specific but in your case vigorous walking and cycling are both eccentric activities and one causes symptoms and the other doesn't. That needs to be investigated a bit. Also, could you provide or share some information which has led you to believe you are suffering from compartment syndrome?
Regards
Prachi

[AnnieDC]

Thank you Prachi for your interest, I am able to answer all of these questions;

1. Location of pain; mainly medial aspect of left lower leg going down past medial malleolus into arch of foot for last 3 years. Also the last 18 months pain in the sacrum buttock area of same leg.
2. I have pain whenever I walk (any walking not vigorous), I also have pain if I cycle too vigorously. Pain starts 5 - 10 mins into walking and will stop some time after I stop. This stop start pain has been going on for 3 years. It has got worse the length of time before pain appears has shortened and the pain more intense.
3. Never any change in pain related to posture sitting or standing
4. Not low back but yes pain tightness in sacrum buttock area - this started around the same time as leg pain but has got worse in last 18 months.
5. Yes pain intermittent but in last 6 months felt constant - better since starting on amitriptyline
6. Yes both matter can walk for about 20 minutes but in pain before I have to sit down.
7. I do lots of yoga and have virtually no pain when doing this - have noticed tightness in left hip with extension beyond anatomical position and internal and external rotation at the hip.
8. Have lots of neurogenic symptoms incl pins and needles, burning sensation, slight swelling, slight numbness. Not yet noticed any weakness in the ankle foot. Unalbe to tolerate heat and limb swells and burns at night if under blanket so autonomic nervous system presumably affected as well.


Seen a surgeon and a sports doctor who suggested Compartment Syndrome - trying to organise a pressure monitor at the moment . Surgery brings its own risks and I am very unkeen on this - I am fit healthy otherwise and don't want a permanant disability,

Any suggestions are very welcome,
Thank you,