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Treatments and drugs
By Mayo Clinic staff
Options to treat chronic exertional compartment syndrome include both conservative and surgical methods. However, conservative measures have proved to be much less effective.
Conservative options
Your doctor may initially recommend trying pain medications, stretching or strengthening regimens, orthotics, massage, taking a break from exercise, or adopting different biomechanical techniques, such as changing how you land when you jog. However, these kinds of conservative options typically don't provide lasting benefit for true exertional compartment syndrome.
You can also consider switching to a different sport. For instance, if your symptoms are related to jogging, try biking instead. Many people, however, aren't willing to give up a beloved sport.
Surgical options
Surgery is the main treatment of chronic exertional compartment syndrome, and the most effective. Surgery involves operating on the fascia — that inelastic tissue encasing each muscle compartment. Surgical methods include either cutting open the fascia of each affected compartment (fasciotomy) or actually removing part of the fascia (fasciectomy). In either case, this release or decompression means the compartment is no longer trapped by the unyielding fascia, giving it room to expand when pressure increases.
Although surgery is highly effective for most people, it's not without risk. Complications of the surgery can include infection, permanent nerve damage, numbness and scarring. In addition, since your muscles will no longer be encased by fascia, they may bulge out during exercise, creating a cosmetic concern.
There also are different ways to perform each type of surgery. For instance, surgery that involves smaller incisions may leave smaller scars but could make it more difficult for your surgeon to navigate through the internal tissues — muscles, nerves and blood vessels — leading to a higher risk of complications. In addition, some surgeons prefer making just one incision, while others prefer two. Be sure to talk to your doctor about the method that's best for you and about how long you will need to wait before returning to exercise and activity. Be sure to follow post-surgical instructions your doctor will give you to ensure a smooth return to your sport.
