Differences between lymphedema, lipedema, and venous swelling

wildshaw1
Jan 23
3 min read

Updated: Feb 6

Source: Research Gate. Lymph node stations of the leg.

Swelling in the legs or arms can be alarming and uncomfortable.

Many people confuse lymphedema, lipedema, and venous swelling because they all involve swelling, but these conditions have different causes, symptoms, and treatments.

Knowing the differences can help you seek the right care and manage symptoms effectively.

Talk to your GP if you have any concerns and to attain the right diagnosis and support.

What Is Lymphedema?

Lymphedema happens when the lymphatic system, which helps drain excess fluid and fight infections, is damaged or blocked. This causes fluid to build up, usually in the arms or legs, leading to swelling.

Causes: It can be inherited (primary lymphedema) or caused by injury, surgery, infection, or cancer treatments (secondary lymphedema).
Symptoms: Swelling that starts gradually, feeling heavy or tight, skin thickening, and sometimes infections.
Treatment: Focuses on reducing swelling through compression garments, manual lymph drainage (a special massage), exercise, and skin care.

Lymphedema swelling often feels firm and does not go away with leg elevation. It can worsen over time without treatment.

What Is Lipedema?

Lipedema is a chronic condition that causes abnormal fat buildup, mainly in the legs and sometimes arms. It mostly affects women and is often mistaken for simple obesity or lymphedema.

Causes: The exact cause is unknown but may involve hormonal and genetic factors.
Symptoms: Symmetrical swelling in the legs, pain or tenderness, easy bruising, and a soft, nodular feel to the skin. 'Cuffing' around the ankles, elbow or wrists may be evident.
Treatment: Includes compression therapy, specialized massage, healthy diet, and sometimes surgery to remove excess fat.

Unlike lymphedema, lipedema swelling usually spares the feet and does not respond well to weight loss alone.

Source: Lymphatic Education and Research Network

Learn more through the Lymphatic Education and Research Network:

Lipedema, the disease they call FAT | Lymphatic Education & Research Network

What Is Venous Swelling?

Venous swelling, also called venous insufficiency, occurs when veins have trouble sending blood back to the heart. Blood pools in the legs, causing swelling and discomfort.

Causes: Weak or damaged vein valves, deep vein thrombosis, obesity, or prolonged standing.
Symptoms: Swelling that worsens during the day, aching or heaviness, varicose veins, skin discoloration, and sometimes ulcers.
Treatment: Elevating legs, compression stockings, exercise, and in some cases, medical procedures to repair veins.

Venous swelling often improves with leg elevation and worsens after standing for long periods.

How to Tell Them Apart

Here are some quick tips to distinguish these conditions:

Stemmer test pinch: Pinch a fold of skin at the base of a toe or finger. If you can't lift the skin (positive Stemmer test) it is a possible indicator of lymphedema. Talk to your GP about your concerns and diagnosis.
Location of swelling: Lipedema usually affects legs symmetrically but spares feet; lymphedema often includes feet; venous swelling affects lower legs and ankles.
Texture: Lymphedema skin feels firm and thickened; lipedema skin is soft and nodular; venous swelling skin may show discoloration or ulcers.
Response to elevation: Venous swelling improves with leg elevation; lymphedema and lipedema do not improve much.
Pain and bruising: Lipedema causes pain and easy bruising; lymphedema may cause discomfort; venous swelling causes aching.