Nonsurgical Treatment for Chronic Compartment Syndrome

If chronic compartment syndrome is causing pain, weakness, numbness, or tightness in your muscles during or after exercise, your NYU Langone doctor may recommend avoiding high-impact exercise and using custom orthotic shoe inserts to relieve stress during physical activity.

If symptoms persist or worsen, your doctor may recommend surgery.

Activity Modification

NYU Langone doctors recommend that people with chronic compartment syndrome rest the affected muscles. Avoiding the activity that causes symptoms can relieve pain and tenderness and prevent compartment syndrome from worsening. Low-impact workout routines, including swimming and cycling, are effective ways to maintain fitness without risking elevated pressure in the muscle compartments.  

It may take weeks or months for symptoms of compartment syndrome to completely disappear, and recovery time varies depending on the severity of the condition. After you’ve healed, you may gradually incorporate exercise into your routine, as long as the pain does not return. 

Runners may find that choosing a softer running surface—for example, dirt trails or a track instead of concrete—may make running more comfortable.

Medication

Doctors may recommend non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen to reduce inflammation and swelling in the affected muscle compartments and alleviate pain. These medications are available without a prescription and are taken by mouth.

Orthotics

Improper footwear may cause or worsen chronic compartment syndrome in the leg. NYU Langone doctors advise wearing shoes that have ample arch support and a cushioned sole when exercising. 

If you have a flat midfoot arch or another structural problem, this may affect how the weight of the body is distributed across the foot during exercise. Over time, this uneven alignment may lead to increased pressure on certain muscle groups and increase the risk of chronic compartment syndrome. Podiatrists or physical therapists at NYU Langone can custom-fit orthotic shoe inserts to improve your foot’s alignment. 

Orthotic inserts are soft but firm foot or heel pads that are inserted into the shoe. When positioned correctly, inserts can correct abnormal foot posture and relieve muscle pain caused by walking and running. For those with chronic compartment syndrome, an orthotic shoe insert may redistribute weight across the foot in a way that allows you to continue running or participate in other high-impact activities without muscle pain.

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