Compartment pressure testing

The cost of compartment pressure testing with Circle Health Group depends on a variety of factors, including which hospital you choose as well as the extent of testing you need. We'll make sure you know the exact price of your tests before you choose to have them.

If you have private health insurance, compartment pressure testing may be covered by your provider. Speak to your insurer directly to find out more information on this.

If you have any questions about our fixed-price packages and flexible payment options, you can speak to a friendly member of our advisory team on 0141 300 5009

You may need a pressure test for compartment syndrome if you struggle with pain in your lower legs while running or performing another activity that puts strain on this area. These symptoms can show up with anyone, but are usually felt by athletes who run on a regular basis. When you run frequently, you may feel a burning pain in the same muscle compartment of both legs that gets worse as you continue to exercise. Symptoms that suggest you might benefit from compartment pressure testing include:

• Aching, burning, or cramped feeling in the lower legs
• Tightness
• Numbness or tightness
• Weakness in the affected limb
• Foot drop (difficulty lifting the front part of your foot)
• Swelling or bulging of the area in question

If the pain you feel when exercising follows the below pattern, it is likely that you have chronic exertional compartment syndrome, but you will need compartment pressure testing to confirm this.

• Pain tends to start after a particular time, distance, or level of intensity when doing exercise that strains your lower legs
• The pain gets progressively worse as you keep exercising, feeling as if your legs are swollen or 'full'
• Pain becomes less intense, or stops entirely, about 15 minutes after stopping the exercise
• Recovery time increases every time

Compartment pressure testing is used when you are showing signs of chronic exertional compartment syndrome. The condition mainly develops when you frequently do exercise that involves repetitive straining and impact on your lower legs, putting constant pressure on muscle compartments in this area. Due to the way compartment pressure testing allows us to read the precise levels of pressure in each muscle compartment as you are exercising, it is the gold standard for determining whether you have chronic exertional compartment syndrome.

Through this test, your consultant will be able to understand the exact severity of the problem. If you have chronic exertional compartment syndrome, it means the leg muscles that have grown due to constant exercise start to press against the casing of tissue that surrounds the muscle (known as the fascia). This pressure inside the muscle compartment creates pain, and can also be a primary cause of exertional leg pain (known better as shin splints). The device used by your consultant during pressure testing for compartment syndrome takes live readings of your exact pressure levels.

When you first see your consultant, they will ask questions about your medical history, checking whether you have experienced the same lower leg pain before. Learning how long the problem has been going on for, along with where the pain lies and what kind of activities you do, is an important part of deciding whether you need pressure tests for compartment syndrome.

Having picked up this information from you, your consultant will perform a detailed physical examination to rule out, or rule in, any other potential causes of exercise-induced leg pain. This may involve them checking the following:

• Performance of your bones, muscles, and joints
• Your circulation
• Metabolism (how your body conserves energy)
• Brain/spinal cord health

This assessment is particularly important, as it helps us confirm if you have any clotting disorders, metalwork from previous surgery, or take blood-thinning medications. If any of the above applies to you, you could be unsuitable for compartment pressure testing.

To make sure that compartment pressure testing would be right for you, we might also run an X-ray, MRI, or CT scan, along with blood tests. If your consultant determines that you should have the procedure, an appointment will be made, which can often be done on the very same day.

We recommend that you go for several runs in the days leading up to your pressure test for compartment syndrome, as this boosts the chances of you reproducing the actual symptoms on the day, allowing for a more accurate diagnosis. At the same time, be sure to come to the appointment well rested. You may be asked to run quite vigorously, so eat nutritious food and drink plenty of water before you see your consultant to avoid feeling lightheaded from the exertion.

Please allow around 60 to 90 minutes for this procedure. You will need to bring your own running attire, running shoes, and gym towel.

To start with, your consultant will inject a small amount of local anaesthetic into your skin that covers the muscle compartments causing you trouble. You will then be asked to jog/run on a treadmill until the pain shows up.

At this point, your consultant will ask you to step off the treadmill, so that they can perform the pressure test for compartment syndrome. This involves inserting a needle into the same area where they applied the local anaesthetic. This is just a small needle; you might experience some mild discomfort, but not for long. The needle is attached to a device that reads the pressure in your muscle compartments in real time. A reading will be taken one minute after exertion, with another reading five minutes later.

They may then connect this needle to a slit catheter - a thin, flexible tube that can be safely placed into your skin and allows for continued measurement of pressure in muscle compartments. After further monitoring of pressure levels inside your muscle compartment while exercising through the slit catheter, your consultant will have all the data they need to confirm whether you have chronic exertional compartment syndrome. Any pressure above 30mmHg is considered a reliable indicator of you having the condition (normal pressure is between 0mmHg and 8mmHg).

After the pressure testing for compartment syndrome has been completed, you might feel a bit tired. We recommend that you refrain from intensive exercise for 24 hours after the procedure (sprinting, playing 90 minutes of football, etc.), but you can still go for a light run or perform any other activity that you do regularly during this period.

A clean dressing will be applied over the site of the injection. Please note that this injection is relatively small; any signs of it will be gone in a couple of days. Your consultant will then discuss the readings with you and walk you through the next steps. If the pressure testing for compartment syndrome confirms you have the condition, your consultant will most likely prescribe rest (so that pressure in the muscle compartment can go down) followed by some tailored physiotherapy exercises, such as changing how you run. In some cases of chronic exertional compartment syndrome, surgery may be required.

Pressure tests for compartment syndrome are straightforward. Our specialists carry out many compartment pressure tests throughout the year, and they are generally completely safe. You might experience a bit of bruising at the site of the injection, but this will go down quickly.

We take extreme care to ensure any needles used are always completely sterilised. Nonetheless, there are always some potential (but extremely rare) complications whenever injections are made, including infection where the needle is inserted, haemorrhage, or development of an acute compartment syndrome in the event of a blood vessel being damaged during the procedure.

If you develop severe pain, temperature, or swelling in the 24 hours after compartment pressure testing, please get in touch with us.

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to align with your routine
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans adapted to your particular needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages that include aftercare
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about our pressure tests for compartment syndrome, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in October 2022. Next review due October 2025.

¹Chronic exertional compartment syndrome testing: a minimalist approach, BMJ Journals