Severe and difficult to control pain, pain out of proportion to examination, and pain with passive stretch of the limb are the hallmark symptoms of this disease. Nerve dysfunction often accompanies the pain and is manifested by burning or dysesthesias in the sensory distribution of the nerve. Motor function can be impaired as well. On exam, the compartment is often swollen, firm, and tender to palpation. The 5 P's of compartment syndrome (pain, paresthesias, pallor, poikilothermia, and pulselessness) need not all be present to make the diagnosis. The affected limb can maintain temperature, color, and detectable pulse until late in the disease process. Symptoms may begin within a few hours of the injury or up to 48 hours after the event.