Women in particular often suffer from heavy, swollen legs in the evening. Thick legs can have different causes and are initially no cause for concern. However, if the legs are permanently swollen, a doctor should be consulted to rule out lipoedema as the cause. Lipoedema is a distribution of fat distribution, also known as a rider's phenomenon or columnar leg. With the right therapy, a lipoedema can indeed treat, but a cure is not yet possible.
What is lipoedema?
Lipoedema occurs almost exclusively in women. The disease causes deposits of subcutaneous fatty tissue, which lead to swelling in the affected body parts. With the progression of the disease, the accumulation of fatty tissue widening more and more.
The fat deposits usually arise symmetrically on the thighs, hips, buttocks, inside of the knee or upper arms, later on the forearms and thighs to the ankles. Back and back of the hand are affected only at extreme severity levels. Typical for the clinical picture of lipedema is a slender upper body, so that the legs are overly thick.
Symptoms of lipedema
Lipoedema patients usually suffer from fat legs with visible deposits of fatty tissue. Especially after prolonged sitting or standing or on warm days, the legs often swell even further due to additional water retention.
Rarely do the symptoms also affect the arms. The following symptoms can also be observed on the affected parts of the body:
- Pain on touch
- Severity, pressure and tension
- bruises after small bumps
- Spider veins
- coarse, partly gnarled skin and orange peel (cellulite)
- cool, badly perfused skin
Causes of lipedema
The exact causes of lipoedema are not yet clear. Probable are a genetic predisposition and hormonal triggers. Lipoedema often occurs for the first time during or after puberty, pregnancy or menopause.
Obesity is not one of the causes, but it can negatively affect the course of the disease.
In men, lipoedema occurs only in exceptional cases, for example, in a hormone disorder as a result of liver damage or hormone therapy.
Diagnosis of lipedema
The diagnosis of lipedema is based on visual and tactile findings (inspection and palpation), the patient's history and, if necessary, on the basis of an ultrasound finding. Above all, a specialist should rule out that the symptoms were caused by other diseases. Here are, for example, the following diseases in question:
- Adipostas (obesity), which often occurs along with lipoedema
- Lipohypertrophy (a harmless fat accumulation) that can develop into lipoedema
- Lymphedema (fluid retention), which usually occurs asymmetrically
Whether it is lymphedema or lipoedema, shows the so-called Stemmer's sign. If the skin lifts on toe or finger folds, it is probably lipoedema.
Stages of lipedema in the disease process
Lipoedema is not curable and can even get worse as the disease progresses. Especially if they are left untreated. Thus, the fat pads in stage 1 occur mainly on the hips, thighs and the inside of the knee. The skin is typically feinknotig (orange peel).
As the disease progresses, the skin in stage 2 appears grossly nodular with dents ("mattress phenomenon"), until at stage 3 large skin flaps and bulges finally develop. The lipoedema can extend to the ankles and overlap. One speaks then of the so-called "pillar leg". Finally, fingers and toes are affected - this is the highest severity.
Lymphedema as a result of lipedema
During the course of the disease, fat cells enlarged and deformed by lipoedema increasingly hinder the outflow of lymphatic fluid. As a result, water accumulations, so-called lymphoedema, develop in the cell interstices. These then cause swelling of the hands and feet.
If lipoedema remains untreated for years, the large lymphatic vessels are also affected by this outflow disorder. One speaks then of a Lymphödem or a Lipolymphödem, as mixed form of Lipo and Lymphödem.
Decongestion therapy for lipoedema
The basis for the treatment of lipedema is decongestive therapy. It requires the daily wearing of compression stockings or dressings to reduce or maintain the size of the lipoedema. Especially during sports compression stockings should always be worn to support the fabric.
Compression devices are also used in the framework of the "apparative intermittent compression" (AIK). The compression of the lymph tissue can relieve the pain and counteract the progress of the disease.
Manual lymphatic drainage, a special type of massage, can additionally promote the removal of edema. Lymphological physiotherapy also includes functional rehabilitation and respiratory physiotherapy. However, these special treatments should only be done by specialists and not by massage therapists who have no training in the field of lymphatic drainage.
Other forms of treatment for lipoedema
The affected lymphoid tissue can not regress. In lipoedema, only surgical liposuction (liposuction) can remove the pathologically altered fatty tissue. However, there is a risk of destroying the superficial lymphatic vessels, which may result in additional lymphedema.
In lipedema, liposuction is often only a temporary improvement, because fatty tissue is more likely to develop again, unlike healthy patients. A detailed consultation by a specialist is therefore indispensable. In addition, sufferers should be aware that the costs of liposuction are usually not covered by the health insurance companies.
In alternative medicine, such as homeopathy, Schüssler salts and jojoba oil are used to treat lipoedema.
Lipoedema patients can do that themselves
Sports and healthy eating are important treatments for lipoedema, although they can not reduce lipedema. Regular exercise and a long-term change in diet, however, help to avoid excess obesity. The increase in the patient could favor the progression of the disease.
Physical activity also reduces water retention. Avoid targeted muscle growth in the affected areas and sports that require jerky movements. For example, easy walking or aqua gymnastics are suitable.
Skin care relieves the symptoms
Since lipoedema can disrupt the microcirculation of the skin, it is more susceptible to inflammation and scarring. Therefore, you should pay attention to a suitable skin care in lipoedema.
The sensitive skin should be carefully creamed with a special moisturizing lotion and not irritated by tight clothing or self-massage. Particularly suitable for the care are pH skin-neutral soaps and creams containing urea or dexpanthenol.
Mental consequences of lipoedema
Lipoedema is often a heavy psychological burden for those affected. Patients suffer not only from physical pain, but also from mental illness.
The negative reactions of people, the deterioration of the quality of life and the frustration of unsuccessful diets and exercise programs sometimes lead to depression or eating disorders. Psychological support is therefore always a successful therapy for lipedema.