Is it possible to avoid surgery for compartment syndrome of the forearm? I'm a brick layer and I need my arms for work everyday. I can't really take time off for an operation.
Compartment syndrome is a potentially serious condition. Pressure within the compartments of the forearm builds up and cuts off the blood supply to the muscles. Rest and changing the way you do things may help. But activity modification may be difficult in a profession such as bricklaying where you perform the same actions over and over.
In fact, it's this chronic repetitive overuse of the muscles that eventually leads to compartment syndrome. The primary areas affected are the compartments separating groups of muscles (and the muscles) in the forearm. Fascia (sheaths of connective tissue) separate the compartments. It's these bands of fibrous tissue that constrict the space. Inflammation in the confined compartment takes up any extra space. Muscles cannot contract and expand. Increasing pressure keeps the cycle of pressure - restriction - blood loss - inflammation - pressure going.
Without prompt treatment, nerve damage and muscle death can occur. If your symptoms are not reduced or eliminated with conservative care, surgery may be needed. Don't delay treatment at any step in this process. Keep close contact with your physician in order to modify treatment as needed.
In some cases, surgery to release the constricting fascial bands (called a fasciotomy) is a faster way to recovery. The surgery, recovery, and rehab can have you back to work in three to six weeks. Conservative care can take much longer to reduce inflammation and restore the tissues to normal.
Your surgeon can help you make this decision based on your symptoms, work history, and the clinical presentation.
Dana P. Piasecki, MD, et al. Exertional Compartment Syndrome of the Forearm in an Elite Flatwater Sprint Kayaker. In The American Journal of Sports Medicine. November 2008. Vol. 36. No. 11. Pp. 2222-2225.
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