Abstract

Chronic Exertional Compartment Syndrome (CECS) is a potentially disabling condition that can cause lower leg pain, increased intramuscular pressure, decreased strength, and other neurological symptoms. Current conservative treatment options fail at a high rate, leading to individuals discontinuing their current level of activity, or electing for surgical fascial release. However, even with surgical fascial release, CECS patients experience a relatively high recurrence of symptoms. One non-surgical treatment method has been the use of botulinum toxin-A injections into the affected lower leg compartments. Based off the available literature, botulinum toxin-a appears to reduce pain and intramuscular pressure in CECS patients. While there are potential adverse effects to the use of botulinum toxin-a, these can often be mitigated using proper dosing and approved botulinum toxin-A preparations. More research is needed to fully understand the mechanism how botulinum toxin-a improves CECS symptoms. In the interim, with proper usage, patient education and communication, botulinum toxin-A has the potential to be a safe and effective treatment option for CECS patients.