A Multidimensional Assessment of Central Sensitization and Pain in Lipedema: Associations with Sleep and Quality of Life in a Case-Control Study

OBJECTIVE: To comprehensively characterize pain in women with lipedema and evaluate its relationship with central sensitization, neuropathic pain characteristics, pain sensitivity, sleep quality, and quality of life. DESIGN: : A cross-sectional controlled study. SETTING: Department of Physical Medicine and Rehabilitation, Ankara Bilkent City Hospital. SUBJECTS: 59 women with Type 2-3, Stage 1-3 lipedema and 59 age-matched healthy controls. METHODS: Pain intensity, neuropathic pain characteristics, symptoms related to central sensitization, pain catastrophizing, sleep quality, health-related quality of life, and pressure pain thresholds were assessed using validated questionnaires and pressure algometry. RESULTS: Compared with healthy controls, women with lipedema had significantly higher pain intensity, painDETECT, Central Sensitization Inventory, pain catastrophizing, and sleep disturbance scores, whereas pressure pain thresholds and all Short Form-36 domain scores were significantly lower (all p < 0.001). Clinically significant symptoms related to central sensitization (Central Sensitization Inventory ≥40) were present in 78.0% of patients versus 8.5% of controls. These associations remained significant after adjustment for age and body mass index. Although pain intensity, painDETECT scores, and pressure pain thresholds were associated with disease stage, Central Sensitization Inventory scores were not. CONCLUSIONS: Pain in lipedema extends beyond local adipose tissue changes and is associated with widespread pain sensitivity, symptoms related to central sensitization, impaired sleep, pain catastrophizing, and reduced quality of life. These findings support a multidimensional approach to pain assessment in lipedema.