Multidimensional Assessment of Pain and Related Factors In Lipedema: A Controlled Clinical Study

Background: Lipedema is a chronic adipose tissue disorder characterized by pain, tenderness, and functional limitations, yet the underlying factors contributing to pain and neuropathic symptoms remain unclear. This study aimed to evaluate pain severity, neuropathic pain characteristics, and associated clinical factors in patients with lipedema compared with healthy controls. Methods: This cross-sectional controlled study included 20 women with clinically diagnosed lipedema and 20 age-matched healthy controls. Demographic characteristics and serum vitamin D and vitamin B12 levels were evaluated in both groups. Pain intensity (VAS), neuropathic pain characteristics (LANSS and DN4), and health-related quality of life (SF-12) were assessed in the lipedema group. Lipedema type and stage were determined clinically. Between-group comparisons, stage-based analyses using the Kruskal–Wallis test with Bonferroni-adjusted pairwise comparisons when appropriate, and Spearman correlation analyses were performed. Results: BMI was significantly higher ( p < 0.001) and serum vitamin B12 levels significantly lower ( p = 0.011) in the lipedema group compared with healthy controls, whereas vitamin D levels did not differ significantly between groups ( p = 0.072). Across lipedema stages, SF-12 Physical scores differed significantly ( p = 0.011), with Stage 3 patients demonstrating poorer physical functioning than Stage 1 patients (Bonferroni-adjusted pairwise comparison, exact p = 0.003). No significant stage-related differences were observed in VAS, LANSS, DN4, vitamin D, vitamin B12, or SF-12 Mental scores. In correlation analyses, LANSS was positively correlated with VAS (ρ = 0.529, p = 0.017) and DN4 (ρ = 0.521, p = 0.018). VAS was negatively correlated with SF-12 Physical scores (ρ = −0.613, p = 0.004), and age was negatively associated with SF-12 Physical scores (ρ = −0.603, p = 0.005). Serum vitamin D levels were also inversely correlated with age (ρ = −0.485, p = 0.030). Neither vitamin B12 nor vitamin D levels were significantly associated with pain severity, neuropathic pain measures, or SF-12 scores. Conclusion: Patients with lipedema demonstrated clinically relevant pain and neuropathic pain features. A higher clinical stage was associated with poorer physical functioning, whereas serum vitamin B12 and vitamin D levels were not associated with pain severity or neuropathic pain measures. These findings underscore the importance of comprehensive pain assessment and functional evaluation in the clinical management of lipedema.