What is the prognosis of lipoedema?
Lipoedema is a progressive condition, however the rate of progression varies between patients. Furthermore, the presence of co-morbidities such as generalised obesity, lymphoedema, peripheral vascular disease and diabetes can significantly worsen symptoms and quality of life. Lipoedema women who pursue an active lifestyle, eat a balanced diet and maintain their weight generally have a better prognosis than those who do not.
Treatments for lipoedema can be broadly divided into non-surgical therapies and liposuction.
Non-surgical therapies do not reduce the volume of limbs but can provide relief of symptoms, such as pain and oedema. Furthermore, there is no evidence to indicate non-surgical therapies slow progression of the disease. Non-surgical therapies include;
Compression hosiery – may be in the form of below-knee socks, stockings or garments. They work by providing the muscles with a firm resistance to work against, thereby improving the function of the lymphatic system. Fluid within the limb is moved towards the body, where it is drained more easily. Compression on the limb also prevents excess fluid transfer from the circulation into the soft tissue. Compression hosiery is therefore ideally suited for lipoedema women with lipo-lymphoedema or orthostatic oedema.
Manual lymphatic drainage (MLD) – a type of gentle massage that stimulates lymphatic flow, thereby alleviating oedema and associated pain and discomfort. MLD should ideally be performed in combination with compression hosiery or bandaging. Further details regarding MLD can be found at www.mlduk.org.uk.
Intermittent pneumatic compression – a mechanical device that provides massage to a limb using inflatable chambers. The segmental massage encourages lymphatic flow in the limb thereby alleviating oedema and associated pain and discomfort. This therapy may not be tolerated by lipoedema patients who have pressure-induced pain.
Exercise – suitable types of exercise are swimming, cycling and power-walking, which all serve to improve lymph flow).
Weight loss / diet (an anti-inflammatory diet) – has been advocated by many lipoedema patients who report a reduction in oedema and pain.