What is it?
Lipoedema is a chronic progressive condition that predominately affects women; it involves disproportionate deposits of an inflammatory fatty tissue that is painful and often misdiagnosed as simply “Fat” [1-2]. Typically women develop increased fatty deposits in the calves, thighs and buttocks following puberty, causing a pear shape appearance, sometimes it can occur in the arms [3-4]. Often described as Lipoderm or Lipoedema it causes symptoms of:
- sensitivity to touch and tenderness in areas of increased fatty tissue
- increased bruising
- painful joints and reduced mobility
- smooth skin but “bean bag” appearance below surface
- heaviness of legs (or areas affected)
Hypermobility and cold temperature on the legs compared to the rest of the body is also reported [5-6]. Having Lipoedema is not due to over eating, weight loss will not affect the disproportionately large legs and hips, however a healthy diet and exercise promotes healthy mental attitude and targets psychological effects.
Having lipoedema can cause problems with day to day living. The physical effects may cause difficulty with mobility, standing and other medical complications, such as varicose veins and joint pain [7-8]. Often lipoedema can have a negative effect of on body image, low self-esteem and lack of confidence, which has an impact work and life relationships and emotional well-being [9-10].
Lymphatic drainage can be used:
Proper diagnosis and treatment can prevent progression, retain mobility and reduce pain. Lipoedema can result in poor mental health, body image, and self-confidence [11-12]. Lymphatic drainage can help as part of the treatment and management of Lipoedema [13-14]. The gentle action of MLD can help reduce pain, sensitivity and inflammation by stimulation of the body’s lymphatic system to reduce swelling and toxins, and promote relaxation of the sympathetic nervous system to improve well-being.
Treatment Time + Approach:
Following a complete assessment and detailed history, patients will be physically examined and measurements taken. Patients will be asked to remove their outer garments, and comfortably position themselves on the couch. The gentle and rhythmic massage treatment makes direct contact with the skin, working from the trunk outwards (proximal to distal) and lasts between 30 minutes to 2 hours, depending on the areas being covered. MLD may be repeated every 4-6 weeks, then reviewed 6 monthly, after which patients should be reviewed yearly.
Lipoedema has been described by doctors since the 1940’s, and although research is taking place at St Georges Hospital and Royal Derby Hospital to discover the hormonal and genetic link, some families may notice the hereditary occurrence skips a generation, this is not fully understood and there is no cure as yet. Lipoedema is potentially physically disabling and needs to be managed regularly to reduce the severity and progression of the symptoms and debilitating impacts of this condition.
1 Williams, A.F., (2018) Lipoedema—a fat disorder: Considerations for GPNs. Journal of General Practice Nursing.
2 Fetzer, A. and Fetzer, S., (2015) Early lipoedema diagnosis and the RCGP e-learning course. British journal of community nursing, 20(Sup4), pp.S22-S28
3 Todd M (2010) Lipoedema: presentation and management. Br J Community Nurs 15(4 Suppl): S10–16.
4 Fetzer, A. and Wise, C., (2015) Living with lipoedema: reviewing different self-management techniques. British journal of community nursing, 20(Sup10), pp.S14-S19.
5 Tyszczak, P. and Szuba, A., (2018) Lipedema: a clinical entity. Acta Angiologica, 24(4), pp.141-148.
9 Langendoen, S.I., Habbema, L., Nijsten, T.E.C. and Neumann, H.A.M., 2009. Lipoedema: from clinical presentation to therapy. A review of the literature. British Journal of Dermatology, 161(5), pp.980-986.
10 DudekJA, Białaszek W, Ostaszewski P and Smidt T (2018) Depression and appearance-related distress in functioning with lipedema, Psychology, Health & Medicine, 23:7, 846-853, DOI: 10.1080/13548506.2018.1459750
11 Dudek, J.E., Białaszek, W. and Ostaszewski, P., 2016. Quality of life in women with lipoedema: a contextual behavioral approach. Quality of Life Research, 25(2), pp.401-408.
13 Fetzer, A., (2016) Specialist approaches to managing lipoedema. British journal of community nursing, 21(Sup4), pp.S30-S35.
14 Reich‐Schupke, S., Schmeller, W., Brauer, W.J., Cornely, M.E., Faerber, G., Ludwig, M., Lulay, G., Miller, A., Rapprich, S., Richter, D.F. and Schacht, V., 2017. S1 guidelines: Lipedema. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 15(7), pp.758-767.