Exertional paraspinal muscle rhabdomyolysis and compartment syndrome: a cause of back pain not to be missed

Exertional compartment syndrome has been described and implicated in pain syndromes involving several fascial compartments. This entity is classically characterized in the legs, feet and forearms of athletes. We describe a case of acute, severe exertional compartment syndrome of the paraspinal muscles in a young and healthy male ultimately resulting in significant rhabdomyolysis and acute kidney injury. The rarity of the syndrome has prevented the establishment of specific guidelines for management; therefore, we will discuss this case in the context of similar previously reported cases, contrasting the various treatment approaches and outcomes described in previous reports. This discussion outlines a syndrome not commonly considered in the differential diagnosis of back pain.