If there is one symptom of lipedema that most can identify, it is the accumulation of disproportional subcutaneous fat tissue. This fat tissue typically impacts the lower extremities and can be swollen and painful. Recent studies have now shown that swelling in our lower extremities can be seen in all stages of lipedema. Specifically, an increase in extracellular water and swelling are observed for all stages of lipedema. Additional information finds that edema and water storage only increased with each later stage of lipedema. Lipedema treatment begins with a multidisciplinary approach to help alleviate all symptoms. Lymphedema therapists will specifically work on lymphatic drainage, prescribing compression garments, and showing how to properly wear these garments. Wearing compression garments is recommended for the first stage of lipedema and is required for later stages.
The Goal for Compression Therapy
As you can see, compression garments are critical for relief form lipedema. Compression therapy has three goals for successful application: to reduce any discomfort, aching, or limb heaviness while supporting tissue health, to help streamline any uneven or distorted shape while improving movement, and to help reduce edema by reducing any interstitial fluid formation and encouraging venous and lymphatic return.
These three goals are necessary for proper management of your lipedema symptoms. All other forms of lipedema therapy are built upon compression therapy providing relief and benefits. When dealing with limb heaviness, tenderness, and any leg cramping your lipedema therapist will often prescribe medical grade compression. This is the most universally applied treatment in these three areas. The therapy itself is relatively low cost and extremely low risk. This form of compression is effective in helping to manage lobules, ankle, and wrist cuffs that are present with lipedema.
Deterring Any Progression of Lipedema
It is still unknown exactly what pathogenic mechanism is the cause of lipedema, but progressive research has provided answers how our lymphatic system plays a role in the development of lipedema. This research has shown how medical grade compression is able to treat symptoms of lipedema and correct lobules and cuffs. It has also shown that this same type of compression is able to optimize our lymphatic flow and encouraging your inflammatory interstitial fluid to drain. Nodular fibrosis, lobular fibrosis, and progressive dermal fibrosis are all the result of these inflammatory fluids and proteins. As these fibrotic processes continue to progress the more at risk you will be for disability.
Types of Compression
When it comes to progression garments you will hear the term graduated compression the most. This type of compression is based upon the notion that our fluids move from higher pressure to lower pressure. Graduated compression applies 100% compression at the distal end which is typically your ankle or wrist. The compression strength will ease up the further you go up your arm or leg; typically, a 70% compression is applied around your calf or forearm before decreasing to 40% around the thigh or upper arm. Most graduated compression sleeves are medical grade which have been proven to assist with any moderate to high edema.
Generally, our arms require less compression than our legs do. Medical grade compression typically has a pressure strength of 18-20 mmHG for the arms and 30-40 mmHg for the legs. These strengths are based upon research studies on what strength is required to improve lymphatic flow. It is recommended that lower strength compression with 20-30 mmHg be used as an initial step to heavier compression. Higher level compression has been shown to minimize edema and reduce several symptoms of lipedema. Reaching the strength of 30-40 mmHg is a goal for compression therapy for you to reach the maximum potential of benefits
Recommended Types of Compression Garments
The type of compression you need will depend on your stage of lipedema. Early stages typically do not require medical grade compression. Non-medical grade or graduated compression sleeves are usually designed for post-operative recovery from surgery. It is important that the brand of compression you chose is graduated, some brands like Marena and Bioflect are not graduated. The best medical grade graduated compression brands are Sigvaris, Juzo, Medi and Solidea. Most individuals who experience lipedema have some type of interstitial fluid and should be treated with medical grade compression when recommended.
Special Needs for Compression
Placing compression garments on can be difficult for those with lipedema. This is especially true for women who typically have greater out of proportion fat accumulation. This obstruct can be handled with various compression garments that are layered. Many individuals find success with knee high socks that are paired with 30-40 mmHg compression garments around the ankles. This allows for comprehensive coverage without any gaps around the lower extremities. Other patients may benefit from thigh high compression garments under compression shorts that will help keep them in place. This allows compression garments to be different sizes while keeping everything in place. Make sure to discuss your needs with your lipedema physician.