Skip to main content
SpringerLink
Log in

Lipödemschmerz – das vernachlässigte Symptom

Lipedema pain—the neglected symptom

  • Leitthema
  • Published:
Die Dermatologie Aims and scope Submit manuscript

Zusammenfassung

Schmerz ist ein zentrales Kennzeichen von Lipödem. Es erlaubt die differenzielle Diagnose in Abgrenzung zu anderen Fettgewebeerkrankungen. Die Analyse der vielfältigen Aspekte von Schmerz jenseits einer Quantifizierung der Schmerzskalenwerte könnte molekulare Krankheits- und Therapiemechanismen zugänglich machen. Lipödemschmerz ist kausal mit Lipödemfett verbunden. Erste belastbare Daten für periphere sensorische Veränderungen konnten erstellt werden. Gewebegewicht und systemische Entzündung verlieren an Erklärungskraft. Genetik und hormonelle Einflüsse gilt es zu untersuchen. Lipödemschmerz lässt sich derzeit nicht pharmakologisch behandeln. Physikalische Therapie zeigt transiente Erleichterung. Liposuktion zeigt Langzeitwirkung auf Schmerz. Das Potenzial der Modulation der Schmerzerfahrung durch psychotherapeutische Ansätze beginnt, als ein potenziell wirksamer neuer therapeutischer Ansatz in den Blick genommen zu werden.

Abstract

Pain, which is a central characteristic of lipedema, allows differentiation from other fat tissue diseases. The analysis of the multiple aspects of pain beyond a quantification of pain scale scores could make molecular disease and therapy mechanisms accessible. Lipedema pain is causally linked to lipedema fat. First robust data show peripheral sensory changes. Tissue weight and systemic inflammation are becoming less likely as causes for the experianced pain. Furthermore, genetics and hormonal influences need to be investigated. Lipedema pain cannot currently be treated with drugs. Physical therapy shows transient relief. Liposuction has been shown to have a long-term effect on pain. The potential of modulating the perception of pain with psychotherapeutic approaches is emerging as a potentially effective new therapeutic approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Al-Wardat M, Clarke C, Alwardat N et al (2022) The difficulties in emotional regulation among a cohort of females with Lipedema. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph192013679

    Article  PubMed  PubMed Central  Google Scholar 

  2. Allen E, Hines E (1940) Lipedema of the legs: a syndrome characterized by fat legs and orthostatic edema. In: Proceedings of the staff meetings Mayo Clinic, S 184–187

    Google Scholar 

  3. Baumgartner A, Hueppe M, Meier-Vollrath I et al (2021) Improvements in patients with lipedema 4, 8 and 12 years after liposuction. Phlebology 36:152–159

    Article  PubMed  Google Scholar 

  4. Bertsch T, Erbacher G, Elwell R (2020) Lipoedema: a paradigm shift and consensus. J Wound Care 29:1–51

    Article  PubMed  Google Scholar 

  5. Brenner E (2017) Wie kommt der Schmerz ins Lipödem. Lymphol Forsch Prax 21:40–47

    Google Scholar 

  6. Cannataro R, Michelini S, Ricolfi L et al (2021) Management of Lipedema with Ketogenic diet: 22-month follow-up. Life. https://doi.org/10.3390/life11121402

    Article  PubMed  PubMed Central  Google Scholar 

  7. Chakraborty A, Crescenzi R, Usman TA et al (2022) Indications of peripheral pain, dermal hypersensitivity, and neurogenic inflammation in patients with Lipedema. Int J Mol Sci 23:10313

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Cornely ME, Hasenberg T, Cornely OA et al (2022) Persistent lipedema pain in patients after bariatric surgery: a case series of 13 patients. Surg Obes Relat Dis 18:628–633

    Article  PubMed  Google Scholar 

  9. Dadras M, Mallinger PJ, Corterier CC et al (2017) Liposuction in the treatment of Lipedema: a longitudinal study. Arch Plast Surg 44:324–331

    Article  PubMed  PubMed Central  Google Scholar 

  10. Davis KD, Flor H, Greely HT et al (2017) Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations. Nat Rev Neurol 13:624–638

    Article  PubMed  Google Scholar 

  11. Di Renzo L, Cinelli G, Romano L et al (2021) Potential effects of a modified Mediterranean diet on body composition in Lipoedema. Nutrients. https://doi.org/10.3390/nu13020358

    Article  PubMed  PubMed Central  Google Scholar 

  12. Dinnendahl R, Tschimmel D, Löw V et al (2023) Lipedema patients show a distinctly altered Quantitative Sensory Testing (QST) profile. medRxiv:2023.2004.2025.23289086

    Book  Google Scholar 

  13. Erbacher G, Bertsch T (2020) Lipoedema and pain: what is the role of the psyche?—results of a pilot study with 150 patients with Lipoedema. Phlebologie 49:305–316

    Article  Google Scholar 

  14. Gensior MHL, Cornely M (2019) Pain in lipoedema, fat in lipoedema and its consequences: results of a patient survey based on a pain questionnaire. Handchir Mikrochir Plast Chir 51:249–254

    PubMed  Google Scholar 

  15. Halk AB, Damstra RJ (2017) First Dutch guidelines on lipedema using the international classification of functioning, disability and health. Phlebology 32:152–159

    Article  PubMed  Google Scholar 

  16. Hamatschek M, Knors H, Klietz ML et al (2022) Characteristics and patient reported outcome measures in Lipedema patients-establishing a baseline for treatment evaluation in a high-volume center. J Clin Med. https://doi.org/10.3390/jcm11102836

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hardy D, Williams A (2017) Best practice guidelines for the management of lipoedema. Br J Community Nurs 22:S44–S48

    Article  PubMed  Google Scholar 

  18. Herbst KL, Kahn LA, Iker E et al (2021) Standard of care for lipedema in the United States. Phlebology 36:779–796

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hucho T, Dina OA, Kuhn J et al (2006) Estrogen controls PKCepsilon-dependent mechanical hyperalgesia through direct action on nociceptive neurons. Eur J Neurosci 24:527–534

    Article  PubMed  Google Scholar 

  20. Hucho T, Levine JD (2007) Signaling pathways in sensitization: toward a nociceptor cell biology. Neuron 55:365–376

    Article  CAS  PubMed  Google Scholar 

  21. Katzer K, Hill JL, Mciver KB et al (2021) Lipedema and the potential role of estrogen in excessive adipose tissue accumulation. Int J Mol Sci. https://doi.org/10.3390/ijms222111720

    Article  Google Scholar 

  22. Kruppa P, Georgiou I, Schmidt J et al (2022) A 10-year retrospective before-and-after study of Lipedema surgery: patient-reported Lipedema-associated symptom improvement after multistage Liposuction. Plast Reconstr Surg 149:529e–541e

    Article  CAS  PubMed  Google Scholar 

  23. Münch D (2017) Wasserstrahlassistierte Liposuktion zur Therapie des Lipödems. J Ästhet Chir 10:71–78

    Article  Google Scholar 

  24. Nankam Pa N, Cornely M, Klöting N et al (2022) Is subcutaneous adipose tissue expansion in people living with lipedema healthier and reflected by circulating parameters? Front Endocrinol. https://doi.org/10.3389/fendo.2022.1000094

    Article  Google Scholar 

  25. Raja SN, Carr DB, Cohen M et al (2020) The revised international association for the study of pain definition of pain: concepts, challenges, and compromises. Pain 161:1976–1982

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rapprich S, Dingler A, Podda M (2011) Liposuction is an effective treatment for lipedema—results of a study with 25 patients. J Dtsch Dermatol Ges 9:33–40

    PubMed  Google Scholar 

  27. Reich-Schupke S, Schmeller W, Brauer WJ et al (2017) S1-Leitlinie Lipödem. J Dtsch Dermatol Ges 15:758–768

    PubMed  Google Scholar 

  28. Schlosshauer T, Heiss C, Von Hollen AK et al (2021) Liposuction treatment improves disease-specific quality of life in lipoedema patients. Int Wound J 18:923–931

    Article  PubMed  PubMed Central  Google Scholar 

  29. Schmeller W, Hueppe M, Meier-Vollrath I (2012) Tumescent liposuction in lipoedema yields good long-term results. Br J Dermatol 166:161–168

    Article  CAS  PubMed  Google Scholar 

  30. Witte T, Dadras M, Heck FC et al (2020) Water-jet-assisted liposuction for the treatment of lipedema: Standardized treatment protocol and results of 63 patients. J Plast Reconstr Aesthetic Surg 73:1637–1644

    Article  Google Scholar 

  31. Wold LE, Hines EA Jr., Allen EV (1951) Lipedema of the legs; a syndrome characterized by fat legs and edema. Ann Intern Med 34:1243–1250

    Article  CAS  PubMed  Google Scholar 

  32. Wollina U, Heinig B (2019) Treatment of lipedema by low-volume micro-cannular liposuction in tumescent anesthesia: results in 111 patients. Dermatol Ther 32:e12820

    Article  PubMed  Google Scholar 

  33. Cornely M (2005) Terminologie des Lipödems. Phlebologie 35:271

    Google Scholar 

  34. Ryan TJ (1995) Lymphatics and adipose tissue. Clin Dermatol 13:493–498

    Article  CAS  PubMed  Google Scholar 

  35. Marsch W (2001) Ist das Lipödem ein lymphologisches Krankheitsbild. J Lymphol 1:22–24

    Google Scholar 

  36. Brenner E (2009) Plasma – interstitielle Flüssigkeit – Lymphe. Lymphforsch 13(1):35–37

    Google Scholar 

  37. Cornely M, Gensior M (2014) Update Lipödem 2014: Kölner Lipödemstudie. LymphForsch 18(2):66–71

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Translationale Schmerzforschung, Klinik für Anästhesiologie und Operative Intensivmedizin, Uniklinik Köln (AöR), Universität zu Köln, Joseph-Stelzmann Str. 9, Geb. 35, 50931, Köln, Deutschland

    Tim Hucho

Authors
  1. Tim Hucho
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tim Hucho.

Ethics declarations

Interessenkonflikt

T. Hucho gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hucho, T. Lipödemschmerz – das vernachlässigte Symptom. Dermatologie 74, 575–579 (2023). https://doi.org/10.1007/s00105-023-05189-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-023-05189-4

Schlüsselwörter

Keywords

Search

Navigation