![]() ![]() Almost all individuals with lipedema have excess interstitial fluid or lymphedema and therefore should be treated with medical grade graduated compression applied to the areas of the body that are affected. Compression garments sold by manufacturers like Bioflect, Marena, and Veronique and Copper Fit are very popular, but they are not recommended for any individual with symptomatic lipedema as they are not graduated and are not medical grade. The non-graduated post-surgical garments do not aid significantly in the flow of lymph. Perhaps however, individuals with early symptomatic lipedema do not need medical grade graduated compression and would suffice with compression garments that are not graduated or medical grade.Ĭompression garments that are not graduated and were originally designed for post-operative recovery have a uniform compression strength of generally 12-20 mmHg. These individuals still would likely benefit from compression garments. Even this can be a bit tricky because most individuals with characteristic disproportionate fat consistent with early stage lipedema are not symptomatic, so may not technically meet the diagnostic criteria for lipedema. Of course, there are a few individuals with early Stage 1 lipedema who may not have any detectable interstitial edema or lymphedema who may not need medical grade compression. The optimal strength of compression depends on the individual patient and her stage of disease. Individual Recommendations for Compression with lipedema? The progression of the fibrotic processes is highly linked to disability from lipedema. The excess interstitial fluid and its inflammatory proteins and signaling agents seen with lipedema is responsible for nodular fibrosis, lobular fibrosis and progressive dermal fibrosis that occurs with lipedema. Medical grade graduated compression has not only been shown to treat symptoms of lipedema and correct lobules and ankle and wrist cuffs caused by lipedema, but also compression has been shown to optimize lymphatic flow and encourage draining of inflammatory interstitial fluid. While the exact pathogenesis or pathogenic mechanism by which lipedema develops is not known, all current understanding points to the lymphatic system playing a role in the development and progression of lipedema and its symptoms. How Graduated Compression Likely Deters Progression of Lipedema Compression with or without other lymphatic stimulating treatment is an effective first line of therapy for managing lobules, wrist, and ankle cuffs that occur with lipedema. Studies have shown medical-grade graduated compression is the most universally applied effective treatment for reliving limb heaviness, tenderness, and leg cramping and it should be the first line of treatment for lipedema as it is an extremely low risk and relatively low cost and readily available treatment. Compression is the cornerstone on which all other treatments for lipedema are built upon as it is the only treatment that has been shown to benefit every patient with lipedema. (Hardy, 2016)Īll three goals are critical for the management of lipedema. help to reduce edema by reducing the interstitial fluid formation and encourage venous and lymphatic return in lipedema.help to streamline uneven or distorted limb shape and improve movement.reduce discomfort, aching, and limb heaviness as well as supporting the health of the tissue.The goal of compression therapy in lipedema is: What is the Goal of Compression Therapy in Lipedema? ![]() Therefore, we conclude that compression is usually needed in stage 1 lipedema and always needed in stage 2 and 3 lipedema. All of the care guidelines recommend a multidisciplinary approach to treatment involving lymphedema therapists teaching patients manual lymphatic drainage, proper fitting compression garments, and instruction on the proper application of the compression garments. All the Standard of Care Guidelines for the management of lipedema recommend the use of compression for patients with lipedema. We know that extremity edema or lymphedema is associated with multiple inflammatory processes that are responsible for pain, tenderness, and progressive fibrosis of the affected areas. Crescenzi, 2019) Further, the study showed that the edema or extracellular water increased with each stage of lipedema. In a study published this year in the Journal of Lymphatic Research and Biology, Crescenzi, Donahue, and Herbst showed that compared to controls all stages of lipedema have increased extracellular water or swelling. New studies have shown that all stages of lipedema show increased swelling in the lower extremities as measured by Bioimpedence. Lipedema is characterized by painful and swollen fat which accumulates disproportionately in the subcutaneous tissue.
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