Effects of intermittent pneumatic compression on pain in women with lipedema

Background Lipedema is a chronic pain disorder characterized by disproportionate adipose tissue accumulation and pain of the affected extremities. While medical compression therapy is recommended for pain reduction, evidence regarding the additional benefit of intermittent pneumatic compression (IPC) remains limited. The aim of this study was to evaluate the effect of IPC on pain in patients with lipedema already receiving compression therapy. Methods Retrospective investigator-initiated analysis of 100 consecutive questionnaires from women with physician-diagnosed lipedema that underwent a home-based IPC trial provided by a medical device company. Pain intensity was recorded on a 0–10 numerical rating scale (NRS) before initiation of IPC and after 10–14 days of treatment. Information on (obsolete) lipedema stage, body characteristics, compression therapy and manual lymphatic drainage (MLD) was collected. Changes in pain scores were analysed. Results 90 patients already receiving manual lymphatic drainage and compression garments were evaluated. Mean/median age of the participants was 48.8/48 years (SD 13.8). Mean/median body mass index was 32.1/31.2 kg/m 2 (SD 6.7). 5 patients were classified as lipedema stage I, 58 stage II, 24 stage III. Prior to IPC, the mean/median pain score was 6.5/6.0 (SD 1.56), decreasing to 3.8/4 (SD 1.55) after treatment. The mean/median reduction in pain was 2.7/3.0 points (p < 0.001). No patient reported worsening of pain. The (obsolete) lipedema stages did not influence pain scores or pain reduction. Conclusion In this cohort of patients with lipedema already receiving compression therapy and MLD the short-term intermittent pneumatic compression (IPC) use was associated with a significant reduction in self-reported pain. The observed effect was independent of (obsolete) lipedema stage. In addition to pain relief, many patients reported improvements in mobility and tissue quality. Prospective controlled studies are warranted to further evaluate the role of IPC in the management of lipedema.