Do I have Lipedema?
Lipedema and Lymphatic System Health
More recently clients are asking me if I think they have Lipedema and my answer is always, “It’s best to ask your GP that question”.
What is Lipedema?
Lipedema is a chronic loose connective tissue disorder that almost exclusively affects women. It affects nearly 11% of adult women and postpubertal females globally and leads to chronic pain, swelling, and other discomforts due to the bilateral and asymmetrical expansion of subcutaneous adipose tissue (the layer of fat that sits between the skin and muscles).
Diagnosis and misdiagnosis
Presently, lipedema is underdiagnosed and often misinterpreted. It is often misdiagnosed as general obesity, as lipedema adipose is highly resistant to diet and exercise. It is also frequently misdiagnosed as lymphedema, lipodystrophies, or other fat disorders.
Lipedema is however characterised by tenderness to palpation, easy bruising, and the bilateral and asymmetrical expansion of inflamed subcutaneous adipose tissue (SAT).
90% of patients report some tissue pain and descriptors of the pain have often included pressure-induced pain, burning sensation, tingling, numbness and pulling in nature.
In a survey of more than 700 women in the USA with lipedema, participants reported involvement of the hips, thighs, and calves, upper arm fatty deposits were common, and the feet were frequently affected by swelling and pain. Fewer than half of respondents of the survey had tried compression (garments or therapy) or manual lymphatic drainage massage to address pain and swelling, and even fewer had tried liposuction, which are all common management recommendations for this condition.
Why does it occur?
The manifestation of lipedema often coincides with periods of hormonal changes that occur throughout puberty, after pregnancy, or during the menopause stage and may be inherited.
Various reports and hypotheses suggest it is related to vascular and lymphatic dysfunction, altered extracellular matrix composition, dysregulated hormones or metabolism, and potential genetic predisposition.
Considering you’re here to seek out Lymphatic Drainage Massage, let’s dive deeper into the lymphatic system component of this condition.
Our capillaries leak blood/fluid out and into the interstitial space, and this fluid is called interstitial fluid (IF). It is our lymphatic system’s job to take up the IF, and turn it into “lymph” via the lymphatic capillaries. But when Lipedema is present the ability of the lymphatic capillaries is diminished, causing more leakage of IF, allowing more fluid to enter the interstitial space and accumulate between dermal skin fibers rather than being cleared by the lymphatic system.
The excess IF surrounding the fat cells then acts as a source of nutrients, further contributing to the pathological expansion of the fat cells, eventually causing the remodeling of the SAT (subcutaneous adipose tissue).
It‘s a chicken and egg situation currently and remains unclear whether the excessive growth of fat cells is causing damage to the lymphatic system, or if the lymphatic dysfunction is actually a contributing factor to the development of lipedema.
Action
If you’re wanting a diagnosis or to learn more about this condition, please see your GP. You may also want to try Manual Lymphatic Drainage Massage a way to help manage your swelling and or pain.
Book Lymphatic Drainage Massage in Clifton Hill and Fitzroy.
Written by Tarren Hehir, Remedial Massage Therapist trained in Manual Lymphatic Drainage Massage.
References:
Indications of Peripheral Pain, Dermal Hypersensitivity, and Neurogenic Inflammation in Patients with Lipedema
https://pmc.ncbi.nlm.nih.gov/articles/PMC9499469/
Lipedema: Insights into Morphology, Pathophysiology, and Challenges https://pmc.ncbi.nlm.nih.gov/articles/PMC9775665/
National survey of patient symptoms and therapies among 707 women with a lipedema phenotype in the United States
https://pmc.ncbi.nlm.nih.gov/articles/PMC10858625/
