Signs and symptoms of lipedema and lymphedema

Lymphedema is a chronic, progressive disease caused by any reduction in the capacity of the lymphatic system to transport lymph and drain the fluid out of the interstitial space back into the circulatory system. Primary lymphedema is caused by genetic abnormalities of the lymph vessel system. Secondary lymphedema may result from carcinomas and their treatments, from injuries, operations, and infections such as filariae, mycoses, bacteria, and viruses, or from artificial causes.

The leading cause of secondary lymphedema worldwide is filariasis, a tropical disease caused by worms. In Europe, breast cancer and its treatment are the most common cause, with a frequency of 20 - 30 percent depending on the treatment type. Lymphedema not only results in aesthetic problems due to the swelling of an extremity, it also results in functional problems due to pain, heaviness, and restricted mobility as well as psychological problems.

Lymphedema can appear immediately following a risk event, but onset may also be delayed for many years. 

1. Swelling (gradual or sudden)
2. Taut skin and feeling of heaviness in the affected area
3. Complaints such as a tingling or prickling sensation
4. Pitting edema, that is, gently pressing on the affected area leaves an indentation
5. The skin on the 2nd toe can´’t be lifted with two fingers. Instead, it feels firm and tough (Stemmer´’s sign).
6. The natural skin folds on the toes and fingers are severely deepened.
7. Hardening of the affected area (fibrosis)
8. Reddening as a result of severe infections such as erysipelas (St. Anthony´’s fire) 

In our clinic, inpatient treatment is done in the form of daily manual all-body lymph drainage lasting 45 - 60 minutes, intermittent pneumatic compression with the Lympha Press, and pulsed magnetic field therapy followed by lymphatic compression bandaging (bandaging time is not included in the time stated for lymph drainage). Core treatment is done in the afternoon, as are physical exercises that are complemented by therapeutic dancing, low-impact aerobics, relaxation techniques, and Qi Gong once per week.

Daily terrain training -– Lympho-Opt Walking -– and treatments for additional illnesses complements our treatment program. A weight-reduction diet rounds out the day in the clinic. The weight-reduction diet is necessary since excess weight can result in a worsening of the edema. If patients are in pain, they can also receive soft laser therapy, which is also used to loosen scars and fibroses and to alleviate ulcerations.

For ulcerations, footbaths as well as ozone therapy and, later, carbon dioxide bathing can also be used. For fibroses, patients receive additional treatments in an electrostatic field as well as sound wave therapy. In addition, patients are given information about their condition and how to deal with the disease as well as about nutrition and psychological problems that may arise as a result of chronic illnesses.

Lipedema is a disorder of the distribution of fat within the body, usually symmetrical. It appears most frequently on the upper thigh and lower leg but also, less frequently, on the arms. This condition includes accumulation of fluid (edema), particularly in the second half of the day, accompanied by pain due to tension and pressure as well as extreme sensitivity to touch. 

People who suffer from lipedema sometimes develop bruises (hematoma) without any external cause. Lipedema becomes more severe over the years. In the progressed stage of lipedema, lymphedema can also develop. Lipedema occurs almost exclusively in women and is often hereditary. Lipedema can even occur in very slender women, in which case the women will have a slender upper body and slim hips, but very fat legs. Lipedema can occur at any age but it is most common for it to arise during puberty or pregnancy.

In addition, other complaints such as a dull, swelling feeling, sensitivity to touch and pressure, and sensitivity to cold may arise. The sensitivity to touch can go so far that even putting on a skirt or pants results in inexplicable pain in the lower legs. “Spider veins” often develop on the side of the upper thigh. As the condition progresses and massive folds of fat develop, patients experience difficulty walking as the folds of fat impede them. The patient develops knock knees.

• aerobic exercise using compression
• complex physical decongestion (CPD) therapy
• intermittent equipment-based compression therapies  
• compression tights
• psychotherapy
• corrective operation (liposculpture)
• diet (only in order to reduce the excess weight that accompanies the condition) 
• lymphological liposculpture (with lymphological follow-up treatment for about one week, financial aid available)