07/01/2026
💦 The difference between Lipoedema and other lymphatic conditions 💦 and why proper assessment of leg swelling really matters:
In my practice, I meet many women who share a similar concern:
their legs feel heavy, often have some degree of swelling, fatty lumps, tender tissues, bruise easily, and continue to enlarge despite healthy eating and regular exercise.
This understandably leads many to suspect lipedema — but in reality, not all leg swelling or fat distribution is the same.
Several medical conditions can appear very similar on the surface, yet they require very different management approaches. Understanding the distinction can prevent years of frustration and delayed care.
🌸 Lymphedema 🌸
= fluid build-up due to lymphatic dysfunction.
Lymphedema occurs when lymph vessels are damaged (usually due to surgery or injury) , lymph node removal (such as in the case of cancer) causing fluid to accumulate in the tissues.
Signs and symptoms: heaviness, swelling, pitting oedema and a feeling of very tight or thickened skin.
🩺 *Clinical clue:* in the case of lower limb lymphoedema, swelling may be uneven, and the skin at the base of the toes is often difficult to lift (Stemmer sign).
Without proper management, tissue hardening and recurrent infections may develop.
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🌸Lipedema 🌸
= This is a painful fat disorder, with accumulation of lymph fluid
Lipedema is a chronic condition affecting fat distribution, primarily in women. It typically presents symmetrically in the hips, thighs, knees, calves, and sometimes the arms.
🩺 *Key signs:* tenderness to touch, easy bruising, and feet & hands that remain unaffected.
Many women notice that weight loss reduces the upper body, while the legs and arms remain unchanged. Over time, untreated lipedema may also affect lymphatic flow, leading to lipo-lymphedema.
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🌸Chronic Venous Insufficiency🌸
= poor blood return from the feet (up against gravity) in the legs.
When leg veins don’t function efficiently, blood pools (build-up) in the lower limbs, causing the water content of the blood to leak through into the surrounding tissues, resulting in oedema (swelling)
🩺 *What to look for:* swelling that worsens as the day progresses, aching, visible varicose veins, and skin darkening near the ankles.
Advanced cases may result in chronic wounds if left untreated.
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🌸Dercum’s Disease🌸
= localized painful fat deposits
This rare condition causes multiple painful fatty nodules (lipomas).
🩺 *Difference:* pain is usually confined to specific lumps rather than being evenly distributed, as seen in lipedema.
Because it’s uncommon, it is frequently misdiagnosed.
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🌸 Weight-related swelling 🌸
= obesity related swelling
Excess body weight place pressure on veins and lymphatic vessels, leading to leg swelling.
🩺 *Distinguishing factor:* swelling often improves with weight reduction and increased movement — unlike lipedema, where abnormal fat tissue persists.
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🌸Thyroid-related swelling🌸 (Myxedema)
An underactive thyroid can cause generalized puffiness rather than localized limb swelling.
🩺 *Often accompanied by:* fatigue, cold sensitivity, dry skin, and unexplained weight gain.
Appropriate medical treatment usually improves these symptoms.
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🌸Deep Vein Thrombosis (DVT)🌸 – a medical emergency
DVT involves a blood clot forming in a deep vein, usually in one leg.
🚨 *Red flags:* sudden one-sided swelling, warmth, tightness, and pain.
Immediate medical assessment is essential.
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# # # 🧭 A helpful comparison guide
Symmetrical, painful legs with easy bruising → consider lipedema
Firm, uneven swelling → suggestive of lymphedema
Varicose veins + swelling later in the day → venous insufficiency
Sudden one-sided swelling with heat and pain → urgent DVT assessment
Swelling that improves with weight loss → weight-related edema
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💡 Why accurate diagnosis is so important
Each of these conditions requires a tailored treatment plan — from compression therapy and manual lymph drainage to the CORRECT exercise guidance, medical management, or referral for further intervention.
Unfortunately, when swelling is misunderstood or misdiagnosed, women may spend years pursuing treatments that simply don’t address the root cause.
If you’re unsure what’s behind your symptoms, a proper assessment can make all the difference.
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Contact Sr. Roelene Faihst from Lymph Draining + today for your lymphatic needs!
Medical aid registered ✅️
Oncology registered ✅️
☎️ 067 396 8136
✉️ ROELENE@LDPLUS.CO.ZA
🌎 www.lymphdrainingplus.co.za
📌 Durbanville MediClinic
