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Pilot study: rapidly cycling hypobaric pressure improves pain after 5 days in adiposis dolorosa

Authors Karen L Herbst, Thomas Rutledge

Published 20 August 2010 Volume 2010:3 Pages 147—153


Review by Single-blind

Peer reviewer comments 4

Karen L Herbst1, Thomas Rutledge2

1Department of Medicine, University of California, San Diego, California, USA; 2Department of Psychiatry, University of California, San Diego, California, USA

Abstract: Adiposis dolorosa (AD) is a rare disorder of painful nodular subcutaneous fat ­accompanied by fatigue, difficulty with weight loss, inflammation, increased fluid in ­adipose ­tissue (lipedema and lymphedema), and hyperalgesia. Sequential compression relieves ­lymphedema pain; we therefore hypothesized that whole body cyclic pneumatic hypobaric compression may relieve pain in AD. To avoid exacerbating hyperalgesia, we utilized a touch-free method, which is delivered via a high-performance altitude simulator, the Cyclic Variations in Altitude ConditioningTM (CVACTM) process. As a pilot study, 10 participants with AD completed pain and quality of life questionnaires before and after 20–40 minutes of CVAC process daily for 5 days. Participants lost weight (195.5 ± 17.6–193.8 ± 17.3 lb; P = 0.03), and bioimpedance significantly decreased (510 ± 36–490 ± 38 ohm; P = 0.01). There was a significant decrease in scores on the Pain Catastrophizing Scale (P = 0.039), in average (P = 0.002), highest (P = 0.029), lowest (P = 0.04), and current pain severity (P = 0.02) on the Visual Analogue Scale, but there was no change in pain quality by the McGill Pain Questionnaire. There were no significant changes in total and physical SF-36 scores, but the mental score improved significantly (P = 0.049). There were no changes in the Pain Disability Index or Pittsburgh Sleep Quality Index. These data present a potential, new, noninvasive means of treating pain in AD by whole body pneumatic compression as part of the CVAC process. Although randomized, controlled trials are needed to confirm these data, the CVAC process could potentially help in treating AD pain and other chronic pain disorders.

Keywords: bioimpedance, chronic pain, lipedema

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