Lipocura München | Physiotherapeutin Melanie Lorenz behandelt Patientin auf der Liege

Conservative therapy for lipedema

There are several ways to relieve the symptoms without surgery. The following measures are usually aimed at counteracting water retention and restarting lymph flow. This should reduce the swelling in the arms and legs and the freedom of movement can be given back to those affected to some extent.

Decongestion therapy Lipedema

The most important goal of the conservative treatment options is to reduce the water stored in the tissue as much as possible – i.e. to decongest the tissue. This goal can be achieved in many cases with regular lymphatic drainage and compression bandages.

Ketogenic nutrition

Ketogenic nutrition is an effective tool in the fight against overweight and obesity. Reduced carbohydrate intake boosts fat metabolism and breaks down fat deposits to produce ketone bodies that provide the body with energy.

Marina Lommel, founder of Foodpunk, is a nutritionist from Munich and gives you tips on ketogenic nutrition.

Manual Lymphdrainage (MLD)

The principle of lymph drainage is based on the stimulation of lymph drainage. The lymph vessels can increase their activity and, accordingly, the tissue fluid faster when stimulated by lymphatic drainage to be.

Lymphatic drainage involves massaging the areas affected by the accumulation of water with rhythmic and circular movements. Unlike a conventional massage, the treatment is carried out with extremely gentle and not with firm movements.

Afterwards, a bandage can be applied, which is left overnight so that the effect of lymph drainage lasts longer. The decongestion therapy temporarily results in a slight reduction in circumference and in many cases a reduction in pain. However, unfortunately there are no lasting improvements, as the basic problem is not being addressed. Liposuction is ultimately the only way to relieve pain in the long term and restore aesthetics.

Lymphatic drainage for lipedema should be performed once or twice a week. Lymphatic drainage primarily relieves pain in the case of pure lipedema, allowing the compression clothes necessary for conservative therapy to be worn.

Swimming, aqua jogging and aqua gymnastics are even more effective than manual lymph drainage. Due to the water pressure, the lymph fluid is gently decongested. We have compiled helpful information for aquajogging offers in the Munich area.

Compression care

In addition to lymphatic drainage, compression clothes are made for you which, in the case of lipedema, correspond to a flat-knit compression (in contrast to venous disorders with circular knitting compression).

Compression washing increases the pressure in the tissue and ensures that less fluid enters the tissue from the blood capillaries. Additionally, the function of the lymph valves and the flow conditions of the lymph vessels are improved. The pressure on the existing edema distributes it over a larger area and facilitates the discharge or removal of lymph fluid from the lymphatic system.  Finally, the distance between cells and blood vessels is reduced, allowing them to be better supplied with nutrients and freed from waste.

The compression treatment is produced individually for you according to your measurements in a medical supply store and the costs are covered by the statutory health insurance companies. There are tights, a combination of stockings and trousers as well as arm stockings and boleros. It is particularly important that the compression garment really does fit perfectly, as otherwise it cuts in and cannot unfold its full effect.

The compression garment should be worn at all times, except at night. Especially for sports such as jogging and trampolining! Of course, you should not wear compression underwear when swimming. For all other sports, the laundry should always be worn, depending on whether the patient is better off with it.

Drug treatment

It is important to note that lipedema cannot be treated with medication.
Dehydrating drugs should be strictly avoided as they worsen the course of the disease.

Complex physical decongestion therapy (KPE)

As part of a rehabilitation measure, the complex physical decongestion therapy (KPE) can be carried out as an in-patient treatment in a lymphatic clinic. This includes manual lymph drainage, compression, skin care and exercise therapy. This specific treatment lasts about three weeks. In addition, pain and fluid retention in the tissue can be reduced, however, the effects of the disease cannot be reversed significantly. This means that the existing fatty tissue remains largely unalterable.

KPE cures can primarily reduce touch and pressure pain. In addition, a regression of water retention and thus a reduction of the leg circumference of up to 10% can be achieved. The treatment must be carried out regularly.

Disadvantage of all conservative therapies

As stated in the guidelines of the Society for Phlebology, conservative therapy does not lead to the reduction of fat cells, but only to decongestion through improved lymph flow. Although this can help patients for a short time and in the best case the disease does not progress through conservative measures, a permanent improvement of the symptoms does not occur.

Exercise therapy Lipoedema

Although lipedema cannot be “sported away”, regular exercise keeps the cardiovascular system fit and also stimulates lymph drainage. However, the swelling of the legs can increase through sport, so compression clothes should always be worn when exercising. This prevents the blood from making its way up to the heart during exertion and from being pumped into the tissue or under the skin. Since the joints of lipedema patients are usually more stressed, sports such as swimming, aqua gymnastics and aquacycling are suitable.

Lipedema Dewatering

In addition to unwanted fat accumulations, patients have to struggle with water retention. This is why dewatering tablets are often taken for lipedema, but they only aggravate the problem. The active ingredients in the drugs extract the water from the blood vessels themselves. However, the water deposits, as they occur in lipedema, are located between the cells and this is exactly where the dehydrating drugs do not work. The consequences of this incorrect use can be a lack of electrolytes and thrombosis. For this reason, sufferers should avoid dehydration tablets.

Diet Lipedema

Unfortunately, diets for lipedema are largely useless with regard to the diseased fatty tissue. The affected area does not release the energy stores even during regular exercise and a strict diet. The fat remains, while the rest of the body – especially the upper body – becomes less and less. However, this does not mean that lipedema patients should not follow a healthy and balanced diet like everyone else. Because weight gain has a demonstrably bad influence on lipedema. We are happy to give you tips and recommend experts who can advise you on a healthy diet.

AIK and lipedema

The so-called apparative intermittent compression therapy (AIK) is a supplement to manual lymph drainage. However, AIK can only be useful in combination with manual lymph drainage, as free lymph channels are the prerequisite for this. The therapy can be carried out by yourself.  Product names are e.g. lymphamate or lymphapress.