Hypermobility Disorders and Lipedema
Hypermobility disorders, including Ehlers Danlos Syndrome, and lipedema frequently co-occur, with studies reporting hypermobility in 44-58% of lipedema patients compared to approximately 23% in other adipose disorders.[1-2] This association suggests shared underlying connective tissue dysfunction may contribute to both conditions.
Connective tissue laxity appears to affect joint stability, adipose tissue architecture, and may contribute to the vascular and lymphatic dysfunction observed in lipedema, potentially explaining the abnormal fat accumulation and fluid retention.[1][4] In lipedema patients with hypermobility features, there is evidence of this multi-system involvement including musculoskeletal deficits, vascular dysfunction, lymphatic impairment, and gastrointestinal symptoms—all consistent with hypermobility spectrum disorders (HSD).[1]
Does having HSD predispose you or vice versa?
Approximately 60% of lipedema patients recall being hypermobile during childhood, suggesting this may be a predisposing factor rather than a consequence of the disease.[1]
What are the clinical implications of co-existing HSD in lipedema?
Clinical implications include recognizing that lipedema patients with hypermobility features often present with additional symptoms beyond typical lipedema manifestations, such as joint pain (particularly ankles, knees, cervical spine), low muscle tone (55%), and exercise-induced fatigue (70%).[1] Early identification of connective tissue alterations, especially in children with familial predisposition to either condition, may enable timely interventions to mitigate disease progression.[1]
Earlier intervention and identification of HSD in lipedema would help the right treatments get to the right people. In addition to occupational therapy and compression, physiotherapy, tailored exercise, and other treatments directed at hypermobility may further benefit lipedema symptoms. Robust evidence is lacking however, emerging treatments include quercetin, a bioflavonoid that has been proposed to benefit connective tissue through several mechanisms: limiting inflammation and associated tissue degradation, improving local circulation, and promoting a strong collagen matrix.[5] Its antioxidant and anti-inflammatory properties have shown efficacy in various musculoskeletal conditions, including rheumatoid arthritis and osteoarthritis, where it reduces inflammatory cytokines, oxidative stress, and matrix degradation.[6-9]
Sources
- Fiengo E, Sbarbati A. Lipedema and hypermobility spectrum disorders sharing pathophysiology: a cross-sectional observational study. J Clin Med. 2025;14(2):482.
- Beltran K, Herbst KL. Differentiating lipedema and Dercum’s disease. Int J Obes (Lond). 2017;41(2):240-245.
- Wang TJ, Stecco A, Hakim AJ, Schleip R. Fascial pathophysiology in hypermobility spectrum disorders and hypermobile Ehlers-Danlos syndrome: a review of emerging evidence. Int J Mol Sci. 2025;26(4):1654.
- Duhon BH, Phan TT, Taylor SL, Crescenzi RL, Rutkowski JM. Current mechanistic understandings of lymphedema and lipedema: tales of fluid, fat, and fibrosis. Int J Mol Sci. 2022;23(12):6604.
- Teixeira S. Bioflavonoids: proanthocyanidins and quercetin and their potential roles in treating musculoskeletal conditions. J Orthop Sports Phys Ther. 2002;32(7):357-363.
- Goyal A, Agrawal N. Quercetin: a potential candidate for the treatment of arthritis. Curr Mol Med. 2021;21(8):654-665.
- Tang M, Zeng Y, Peng W, et al. Pharmacological aspects of natural quercetin in rheumatoid arthritis. Drug Des Devel Ther. 2022;16:2201-2216.
- Samadi F, Kahrizi MS, Heydari F, et al. Quercetin and osteoarthritis: a mechanistic review on the present documents. Pharmacology. 2022;107(5-6):235-246.
- Mamani-Matsuda M, Kauss T, Al-Kharrat A, et al. Therapeutic and preventive properties of quercetin in experimental arthritis correlate with decreased macrophage inflammatory mediators. Biochem Pharmacol. 2006;72(10):1304-1310.
