Lipedema Management

At Ottawa Cancer and Lymphatics Centre, we specialize in compassionate, evidence-based care for people living with lipedema. Lipedema is a chronic condition marked by abnormal fat accumulation, typically in the legs, hips, buttocks, and sometimes the arms. Lipedema is often misdiagnosed or misunderstood, and many individuals feel unheard or dismissed. Our team is here to change that.

We help clients with lipedema manage symptoms like pain, swelling, heaviness, and limited mobility, while working toward greater comfort, body confidence, and improved quality of life. Whether you’ve just received a diagnosis or have been living with lipedema for years, we are here to support your journey. 

 

What is Lipedema?

Lipedema is a chronic fat distribution disorder that most commonly affects women and is often triggered or worsened by hormonal changes such as puberty, pregnancy, or menopause. It is different from obesity and is often resistant to diet and exercise changes. Lipedema can cause: 

  • Symmetrical swelling in the legs and/or arms (not affecting the hands or feet) 
  • A feeling of heaviness, aching, or tenderness 
  • Easy bruising 
  • Fat pads or nodules beneath the skin 
  • Limited mobility or range of motion 

Lipedema can progress over time and lead to secondary lymphedema or chronic venous insufficiency, making early intervention and supportive care essential. 

 

Services for Lipedema Management 

Our clinic offers a whole-person approach to managing lipedema. We customize your care based on your needs, stage of lipedema, and lifestyle goals. Services include: 

  • Physiotherapy: Our physiotherapists help improve discomfort and function while addressing pain and compensatory strain from uneven weight distribution. They provide education and gentle therapeutic exercise to support lymphatic and circulatory health. 
  • Massage Therapy: Gentle, specialized massage helps reduce pain, improve tissue quality, and promote relaxation. Therapists are trained to accommodate sensitivity and bruising common with lipedema. 
  • Kinesiology: Our kinesiologists create personalized exercise programs focused on low-impact activity, resistance training, and safe cardiovascular conditioning. Movement is carefully introduced to reduce inflammation and support lymph flow. 
  • Laser Therapy: Low-level laser therapy may help reduce pain, soften fibrotic tissue, support lymphatic drainage, and improve skin quality. 
  • Scar Management: If you’ve undergone liposuction or other related surgeries for your lipedema, our therapists help reduce tightness and adhesions, support tissue healing, and restore mobility. 
  • Lymphedema Management: Lipedema often overlaps with lymphedema. Our certified therapists offer manual lymphatic drainage (MLD), compression therapy, and education to manage swelling and prevent complications. 
  • Compression Therapy: We fit and educate you on the use of compression garments that help reduce swelling, provide support, and improve comfort during daily activities. 
  • Dietetics: While diet does not cure lipedema, nutrition plays a role in managing inflammation and maintaining overall health. Our registered dietitian provides individualized plans that support wellness and comfort. 
  • Psychotherapy: Living with lipedema can affect mental health and self-esteem. Our therapists offer supportive, trauma-informed care to help you feel empowered and heard. 
  • Acupuncture: May offer symptom relief, including pain, inflammation, and energy regulation. (Coming soon!) 

We believe that every person with lipedema deserves to feel seen, understood, and supported. You don’t have to manage this condition alone; our experienced team is here to help.

Lipedema is a condition characterized by the abnormal deposition of adipose tissue, typically in the hips, thighs and legs, but stopping before the feet. It can also appear in the upper arms. Lipedema can be very painful, and often leads to capillary fragility, making patients more prone to easy bruising. This condition is also unique to women, often inherited and more common than we think. It is expected that it often goes undiagnosed and is written off as just obesity. “Making the diagnosis relies on some of the hallmark characteristics of lipedema, such as the easy bruising and pain with soft tissue pressure, as well as the step-off at the ankles. Women with generalized obesity typically do not have these history and physical exam characteristics.” (Warren Peled, A. & Kappos, E., 2016).

Lipedema can also be confused for lymphedema, or chronic venous insufficiency. Although these conditions are different and a proper diagnosis is important, they are greatly intertwined and often occur together. In these cases, both conditions need to be considered and treated.

Lipedema is a chronic and incurable disease that requires lifetime maintenance and treatment. Treatment for lipedema still requires ongoing research as we currently do not fully understand the pathophysiology of the disease. Some of the current known therapies to help lipedema can be classified into 2 main categories: conservative treatment and surgical treatment.

Conservative therapies are primarily focused on improving strength, fitness and improving overall health habits. One of these therapies is a change in diet. As mentioned previously lipedema is not simply obesity and when talking about diet it can be a touchy subject as many women with this condition are told numerous times they “just need to eat better and lose weight”. This is an incorrect thinking process as lipedema is actually a complex disease and dietary changes alone will not cure the abnormal adipose tissue deposition. Diet can however greatly reduce inflammation and help ease the pain that is often experiences by those with lipedema (Warren Peled, A. & Kappos, E., 2016). In addition to dietary modifications, it has been demonstrated that physiotherapy is of great benefit to those with lipedema. “The current review [of literature] showed that complex decongestive physiotherapy, gait training, hydrotherapy, aerobic exercise, and resistance exercise training each have value in the management of lipedema.” (Esmer, M. U. R. A. T., Schingale, F. J., Unal, D. A. M. L. A., & Güzel, N. A., 2020). In research completed by Szolnoky, G. et al in 2008 it was observed that complete decongestive physiotherapy significantly reduced capillary fragility inpatients with lipedema and it is theorized that this reduction may lead to reduced hematoma formation. Combined, these therapies can often greatly improve function and quality of life.

In cases of non-response or limited response to conservative therapies, surgical options may be considered. Surgical options can be greatly beneficial to help improve quality of life, but it should be noted that they are not curative and carry risks (Warren Peled, A. & Kappos, E., 2016).

Increased recognition and diagnosis can help lead to earlier interventions and timely access to conservative therapies. This complex medical condition requires lifelong monitoring and varying intervention. In order to optimize treatment for patients in all stages of lipedema, more research is required.

 

 

References:

Esmer, M. U. R. A. T., Schingale, F. J., Unal, D. A. M. L. A., & Güzel, N. A. (2020). Physiotherapy and rehabilitation applications in lipedema management: A literature review. Lymphology, 53(2), 88-95.

Szolnoky, G., Nagy, N., Kovács, R. K., Dósa-Rácz, E., Szabó, A., Bársony, K., … & Kemény, L. (2008). Complex decongestive physiotherapy decreases capillary fragility in lipedema. Lymphology, 41(4), 161-166.

Warren Peled, A. & Kappos, E. A. (2016) Lipedema: diagnostic and management challenges, International Journal of Women’s Health, 8:, 389-395, DOI: 10.2147/IJWH.S106227