Body Matters Practice Newsletter

Volume 13 ■ Issue 04 ■ June  2013  Supplement

DiagnosisEarly diagnosis of Lipoedema isvital to stop symptoms from gettingany worse.

A number of factors are taken intoconsideration when making a formaldiagnosis of Lipoedema:

• Disproportionately larger/fatterlegs and hips compared to theupper body

• Swelling is symmetrical (bothsides of the body are affectedequally)

• Hands and feet are not affectedLoose, floppy connective tissuesaround the knee joints

• Fat that looks like cellulite andfeels soft

• Tenderness/pain and easy orspontaneous bruising to affectedareas

• Skin of affected areas may be paleand cold

• Upper arms may also bedisproportionately fatter

• Patients may report increasedswelling in hot weather

Stages of lipoedema

Common Complications• Lymphoedema • Varicose Veins• Knee pain • Psychological Impact

TreatmentAt present there is no fool-prooftreatment for lipoedema. Evaluationby an endocrinologist and thetreatment of endocrine imbalancesmay help. When lymphoedema isalso present, treating that conditiontakes priority.

What about Liposuction?

Liposuction surgically removesexcessive fat from under the skin.Liposuction has been studied as apotential treatment of lipedema;however, it is not accepted for thispurpose. There is a high risk thatsuch a surgery can actually makethe condition worse.

Although often perceived as beingminor cosmetic surgery, this is nottrue of liposuction. It is an invasiveprocedure that cannot be performedwithout causing additional damageto the lymphatic system that cancause the condition to deteriorate.

What about Gastric Bypass?

Gastric bypass surgery isperformed to bring about the loss ofbody weight. However when apatient has lipoedema, the weightwill not be lost in the areas affectedby that condition. .

What Can Help?Because there is no known cure atpresent, current treatment focuseson preventing the condition gettingany worse and stopping newproblems such as lymphoedemaand varicose veins developing.

Compression garments, maintaininga healthy eating plan and specificexercises all help to preventdeterioration.

Compression Garments

Compression garments are made-to-measure support socks,stockings or tights. Wearingcompression hosiery is the singlemost effective way of slowing downor preventing worsening symptoms.It encourages the flow of blood andlymph fluid, which helps preventfluid retention/oedema and theonset of lymphoedema. Wearingsupport garments prevents poolingof fluid in the tissues and stopstissues becoming pendulous. It alsohelps reduce pain by supportingsoft tissues and painful knee jointsand can help redefine the shape ofthe legs.

Diet

Dieting will not get rid of fat causedby lipoedema so weight lossattempts are pointless for womenwho already have a slim upperbody. It is however important tomaintain a healthy body weight:;putting on weight will aggravate thesymptoms while avoiding weightgain will prevent deterioration.

Exercise

Exercises such as swimming,walking and cycling arerecommended because theyincrease lymphatic drainage andimprove blood flow through theaffected limbs. High impactexercising (i.e. jogging, step-aerobics) may make matters worseand exacerbate joint pain.

Exercising in water is particularlybeneficial. It supports painful jointsand the pressure of deep water onthe legs helps improve lymphaticand venous function. Walking inchest-high water is especially goodbecause it provides graduated,painless compression to the legs.

Manual Lymphatic Drainage (MLD)

This is an advanced medicalmassage which is conventionallyused to treat lymphoedema andimprove lymphatic drainage. Manywomen say it helps to reducelipoedema pain.

In cases of lipo-lymphoedema MLDtreatment is a must to reduce andcontrol the lymphatic swelling.Without MLD treatment the risk ofdeveloping further complications ishuge.

If you have or suspect that youmight have lipoedema speak to AgiSykes our Lymphoedema Specialist

01484 424 329

Body Matters Practice Newsletter

Volume 13 ■ Issue 04 ■  June 2013 Supplement

JUNE 2013 LIPOEDEMA AWARENESS MONTHWhat is Lipoedema?First reported in 1940, lipoedema isa poorly understood, often misdiag-nosed and frequently mismanagedcondition. So far it is not knownwhat causes lipoedema but it isprobably connected to changes infemale hormone levels in the body.As yet, there is no cure.

What is known?

Lipoedema is almost certainly a ge-netic, inherited condition becausethere is often more than one familymember affected. It is thought toonly affect women but there arevery rare reports of men with similarsigns and symptoms

Lipoedema can skip a generation,so a grandmother and granddaugh-ter may be affected but not themother. A woman may have twodaughters with only one affectedbut either daughter may pass thecondition onto their own daughters.It is not clear why it is passed on tosome female family members andnot others.

No gene testing is available. Be-cause lipoedema is so frequentlyundiagnosed or misdiagnosed, it isnot known what percentage of thefemale population suffers from it.

SymptomsLipoedema is most likely to appearat puberty, before which time theaffected girl will most likely havehad a ‘normal’ body shape in thatthe top and lower half of her bodydid not look ‘mismatched’. Howeverlipoedema can also appear duringor after pregnancy or during themenopause. Whenever it firstappears, the symptoms can comeon quite quickly, and the change inbody shape can be dramatic. Thiscan have deep psychologicaleffects: when a young girl or womansuddenly finds she has developed

what some have described as, as‘tree trunk legs’ or ‘thunder-thighs,’despite maintaining a healthy dietand exercise routine, she may beunderstandably distressed.

Unlike normal fat caused by over-eating or lack of exercise, lipoede-ma fat often (but not always) hurtswhen banged or scraped, even gen-tly and it can bruise easily but,again, not all women experiencethis. There doesn’t appear to be anycorrelation between how much ab-normal fat a women has and howpainful it is.

Lipoedema looks and feels differentto normal body fat; softer and dim-pled, like cellulite. It won’t respondto dieting or exercise. Even womenwith lipoedema who’ve developedAnorexia Nervosa still display clearphysical symptoms.

Lipoedema frequently gets worseduring periods of hormonal changesuch as using hormonal contracep-tives, pregnancy or menopause.

Lipoedema andLymphoedemaWhile lipoedema is not a disorder ofthe lymphatic system, lipoedemaand lymphoedema are often con-fused because both conditionsinvolve enlargement of the legs.Lipoedema and lymphoedema aredistinctly different conditions,however, lipoedema can causesecondary lymphohedema todevelop in the feet and the legs.At this stage the condition oflipoedema is re-classified as lipo-lymphoedema.

Distinguishing featuresLipoedema is symmetrical becausethe excess fat involves both legsequally. Lymphoedema is notsymmetrical and often occurs inonly one leg.

Lipoedema swelling has acharacteristic ring at the base of theankle where the swelling stops.Lymphoedema swelling oftenbegins at the foot and there is notring at the base of the ankle.

Lipoedema does not includeswelling of the foot. Lymphoedemaswelling affects the foot, ankle andleg.

Lipoedema patients often complainof pain when touched.Lymphoedema pain is rarely thissevere.

Lipedema often causes bruisingand subcutaneous bleeding.Lymphoedema symptoms do notinclude bruising and subcutaneousbleeding.

Lipoedema does not pit (fjingermarkis left after applying pressure)Lymphoedema does pit.