Lymphedema

Lipedema Treatment at North Carolina Physical Therapy

Lipedema is a connective tissue disorder that primarily affects women and is often misdiagnosed or conflated with obesity, lymphedema, or generalized edema. It is characterized by symmetrical, disproportionate fat distribution —most often in the lower extremities and sometimes arms—combined with tissue tenderness, easy bruising, and pain. Importantly, lipedema is hormonally influenced and frequently emerges or worsens during periods of hormonal change such as puberty, pregnancy, or menopause.

Despite its prevalence, lipedema remains under-recognized in traditional medical settings , often leaving individuals without answers or proper care. At North Carolina Physical Therapy, we offer specialized, evidence-informed care for individuals with lipedema, including those with

co-existing lymphedema, venous disease, or connective tissue disorders such as Ehlers-Danlos Syndrome (EDS).

Your initial evaluation is thorough and includes a review of your medical, surgical, and hormonal history, analysis of fat distribution patterns, and a functional movement assessment. We utilize tools such as the SOZO bioimpedance scan to assess extracellular fluid status and determine whether secondary lymphedema is present, as well as visual and manual tissue grading to assess fibrotic changes and nodularity.

Our multidisciplinary treatment approach is tailored to your clinical presentation and may include:

• Manual Lymphatic Drainage (MLD): to reduce secondary lymphatic congestion and improve tissue health.

• Pneumatic Compression Therapy (PCT): to assist in fluid mobilization and improve limb contour; we assist with qualification or upgrade for home devices when appropriate

• Custom Compression Garments: essential for symptom control and limb shaping, fitted through a trusted local DME provider

• Neuromuscular Re-education and Therapeutic Exercise: to optimize movement efficiency, joint protection, and lymphatic return.

• Education in Nutrition and Lifestyle Modifications: tailored to support anti-inflammatory strategies and long-term symptom management.

We also support patients who are pursuing surgical intervention as part of their lipedema management. This may include lipedema reduction surgery such as Lipectomy or Suction-Assisted Protein Lipectomy (SAPL). Our team assists patients in meeting preoperative criteria for insurance authorization, including functional mobility testing and documentation of conservative care. We also perform specialized Lipedema Functional Testing , which can enhance medical necessity documentation and strengthen reimbursement outcomes for these procedures.

Importantly, lipedema is not reversible through caloric restriction or conventional exercise alone. Our focus is on symptom relief, functional restoration, and patient empowerment through individualized care plans and ongoing education in self-management strategies including

skin hygiene, pacing, exercise, compression compliance, and lymphatic health.

We also understand that many individuals with lipedema have faced invalidation or gaslighting in previous healthcare experiences. Our clinic is a safe, affirming space where your symptoms are believed, your questions are answered, and your progress is tracked with objective metrics and clinical expertise.

If you're living with chronic leg heaviness, swelling, pain, or disproportionate fat accumulation—and suspect or have been diagnosed with lipedema—schedule a comprehensive evaluation today. We’re here to provide answers, offer relief, and guide you toward long-term management and improved quality of life.