Compartment syndrome is rarely seen in a chiropractic practice as most are seen secondary to trauma or require immediate surgical intervention, yet this is why it is even more important for DCs to understand the condition. Despite its rarity, lack of proper diagnosis and treatment can cause permanent damage. This is why training and research into chiropractic care for compartment syndrome is so valuable.
In compartment syndrome, a patient suffers from increased pressure in one of the body’s compartments containing muscles and nerves. Recognition and determine of acute or chronic compartment syndrome are the key to the next step of proper treatment of the patient.
NUHS faculty Dr. Manuel Duarte, chair of clinical practice, and clinician Dr. Sonia Joubert, recently published a case report in the June 2016 Journal of Chiropractic Medicine, based on a patient treated in their private practice who they diagnosed with compartment syndrome.
Their article,”Chronic Exertional Compartment Syndrome in a Healthy Young Man,” documents the case of a 21-year-old patient who sought chiropractic care reporting an inability to run due to foot weakness and paresthesia (the feeling of “pins and needles” or the foot falling asleep.) The patient received an exertion test and compartment pressure test, which diagnosed exercise-induced compartment syndrome.
Sometimes conservative care will improve compartment syndrome. That’s why the patient’s orthopedic surgeon, along with Dr. Duarte and Dr. Joubert, decided on 12 weeks of carefully monitored chiropractic and rehabilitative care. When Dr. Duarte and Dr. Joubert saw no significant improvement in the patient’s condition, they recommended the patient receive fasciotomy surgery. The surgery successfully resolved the problem.
During the patient post-surgical rehabilitation Drs. Duarte and Joubert notice the patient has similar symptomatology developing on his other leg, the patient went through the same diagnostic examination by Dr. Duarte and Joubert who notice the symptoms were of higher intensity than the previous leg. Compartment test confirmed Dr. Duarte and Dr. Joubert’s diagnosis, and the patient was immediately schedule for surgery, which again resolved the problem.
The case is a great example of how good diagnostic skills are critical for chiropractic physicians, and how patients can be served exceptionally well when DCs and MDs co-manage patient cases and corroborate in diagnosis in patient care.
“Good case reports on compartment syndrome are important to the field, because normally DCs may not see these cases very often, and it can help them decide on proper testing and treatment,” says Dr. Duarte. He reports that he and Dr. Joubert were able to help the patient with post-surgical care and rehabilitation. In fact, the patient’s treatment and post-care was so effective that he was able to later successfully complete the demands of U. S. Air Force basic training.