Chronic pain, especially in the lower body, is something many people—primarily women—live with for years without answers. In cases of lipedema, this discomfort is frequently misidentified as joint issues or lingering effects of past injuries. Because the symptoms can overlap, it’s important to understand the distinguishing features of lipedema-related pain. Doing so not only helps validate your experience but also puts you on the right path toward an accurate diagnosis and more effective, long-term relief.
Lipedema is a chronic fat disorder that disrupts the way fat is stored and distributed in the body. It causes abnormal fat buildup, most commonly in the legs, thighs, hips, and arms, and is often accompanied by painful symptoms such as swelling, tenderness, inflammation, and joint pain. In more advanced stages, lipedema can lead to mobility issues and even progress to lipo-lymphedema. While it’s estimated that lipedema affects around 11 percent of women worldwide, it remains widely misdiagnosed and misunderstood.
At Advanced Lipedema Treatment Program at The Roxbury Institute, our team has seen firsthand how often lipedema pain is misattributed to unrelated joint issues. Many women are told their discomfort is due to aging, past injuries, or autoimmune disease, when in reality, lipedema may be contributing to their symptoms.
If you’ve been living with persistent pain and swelling, especially in the lower body, it may be time to consider whether lipedema is playing a role. Gaining a clearer understanding of your symptoms is a key step toward receiving the right care and improving your quality of life.
Lipedema-related joint pain is often linked to painful, inflamed fatty deposits that build up under the skin’s surface, causing hard nodules that create tenderness, redness, bruising, and swelling of the skin, which is one of the key characteristics of lipedema. Lipedema fat is often referred to as “painful fat” or “fat that hurts,” and it differs significantly from the fat seen in obesity or cellulite. While it may appear similar on the surface, lipedema is a distinct medical condition with unique symptoms, progression, and treatment needs. Here’s why. Lipedema fat, when not properly treated with compression therapy and garments, lymphatic massage, or surgery, can exacerbate, causing firm nodules beneath the skin’s surface that are tender to the touch, often leading to joint issues, particularly “knock knees,” flat feet, fatigue, bruising, and mobility challenges. Surgery is considered the gold standard for treatment, especially in moderate to advanced stages, and can significantly improve pain, mobility, and overall quality of life when combined with conservative therapies. Though lipedema can affect the upper body, i.e., arms, it primarily affects the hips, buttocks, legs, knees, calves, and ankles— typically sparing the feet. Hence, joint pain in the lower extremities is one of the key symptoms of advanced stage lipedema and/or untreated lipedema of any stage. Accumulation of fat around the knees, hips, and ankles can lead to unbearable joint pain and immobility and is often misdiagnosed or taken for chronic joint pain due to arthritis, injury, or other degenerative issue. Lipedema joint pain is caused by the abnormal buildup of adipose tissue that can impair an individual’s normal gait, resulting in a feeling of “heaviness” and fatigue in the legs and potentially leading to severe joint pain and immobility.
On the other hand, regular joint pain that is NOT lipedema-related may be the result of any of the following:
Regular joint pain can vary in location, duration, and intensity, and can range anywhere from a dull to sharp to achy feeling. Stiffness and swelling can also occur, especially in the mornings or during cold, damp weather. Joint pain from RA, injuries, or other related issues can leave an individual out of commission for a period of time, reducing mobility and making everyday activities more difficult. The key differences between lipedema pain and regular joint pain are that lipedema joint pain is directly related to fatty deposits around the joints, while regular joint pain can be caused by RA, osteoarthritis, injuries, overuse, gout, tendinitis, etc. Also, regular joint pain can flare up in ANY joint in the body, where lipedema joint pain generally occurs in the lower limbs. Moreover, lipedema can limit full range of motion in the knees due to fatty deposits in the area. Lipedema typically limits knee flexion to 90 degrees, compared to 140 degrees for those without lipedema. It’s important to seek a medical evaluation and diagnosis to determine where your joint pain is originating.
Lipedema does not only cause joint pain. Many individuals living with lipedema experience pain in other areas as well, and it’s important to recognize that this discomfort may be mistakenly attributed to unrelated conditions. Being able to identify lipedema-related pain is key to getting proper care. Below are additional common sources of pain associated with lipedema:
Inflammation
Lipedema-related inflammation can be triggered by hormonal changes, weight fluctuations, pregnancy, dietary factors, heat exposure, chronic stress, and lack of physical activity. This inflammation may lead to increased swelling, aching, and a feeling of heaviness in the affected limbs.
Painful Fat Deposits
One of the hallmark features of lipedema is the development of tender, fibrotic fat beneath the skin. These fat deposits may feel nodular or firm and can cause localized pain, swelling, skin sensitivity, and even flaking or dryness in some cases. This “painful fat” is not the same as fat from general weight gain or obesity.
Lymphatic Dysfunction
Although lipedema is not primarily caused by lymphatic issues, the accumulation of abnormal fat can place pressure on the lymphatic vessels, compromising the body's ability to properly circulate and drain lymph fluid. This can result in swelling, tightness, heaviness, and pain—particularly in the legs. When left unaddressed, this lymphatic burden can progress to lipo-lymphedema, a more advanced and painful condition marked by significant fluid retention and mobility limitations.
At-Home Therapies for Lymphatic Support
Conservative therapies that support the lymphatic system can help reduce pain and manage swelling. These include:
Bruising and Skin Sensitivity
Areas affected by lipedema tend to bruise easily and feel tender to the touch due to the fragile blood vessels within the fatty tissue. Even minimal pressure or minor trauma can result in noticeable bruising, which is another common symptom of the condition.
If you’re living with chronic joint pain—especially in the lower body—and haven’t found relief through conventional treatment, it may be time to consider whether lipedema could be contributing to your symptoms. Lipedema is often misdiagnosed as arthritis, injury-related pain, or another musculoskeletal issue, leading many women to go years without an accurate diagnosis.
You should seek medical evaluation, ideally with a provider familiar with lipedema, if you are experiencing any of the following:
Talking with a healthcare provider about your symptoms can help you receive a proper diagnosis, rule out common misconceptions, and begin a personalized care plan. If lipedema is the cause of your joint pain, early intervention can significantly improve both your mobility and quality of life.
If you recognize any of the signs or symptoms mentioned above, know that you are not alone. At Advanced Lipedema Treatment Program at The Roxbury Institute, Dr. David Amron and his team specialize in the diagnosis and surgical treatment of lipedema. With decades of experience and a deep understanding of this often-misunderstood condition, Dr. Amron offers a comprehensive, personalized approach designed to improve function, reduce pain, and restore quality of life.
If you're struggling with persistent joint pain, swelling, or disproportionate fat accumulation, scheduling a consultation could be the first step toward getting answers, and finally finding relief.
