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Adiposis dolorosa
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Condition

Adiposis dolorosa

Adiposis dolorosa is a rare condition marked by painful subcutaneous fatty tissue and benign lipomas, most common in overweight women aged 35‑50.

Overview

Adiposis dolorosa is characterized by painful fatty (adipose) tissue just underneath the skin (subcutaneous). The pain is often associated with multiple noncancerous (benign) tumors called lipomas. It occurs most often in women between the ages of 35 and 50 who are overweight or have obesity.

Adipose tissue stores fat for energy and provides structural support. In adiposis dolorosa, lipomas develop within this tissue, most often on the torso, buttocks, or the upper arms and legs. The lipomas feel like firm nodules under the skin and can be severely painful, especially when they press on a nearby nerve. In some individuals the pain is disabling.

Additional signs and symptoms may be present, but they do not occur in all patients and their relationship to the condition remains unclear.

Frequency

Adiposis dolorosa is believed to be rare, although the exact prevalence is unknown. The condition is more common in women than in men.

Causes

The cause of adiposis dolorosa is unknown. Although a few families with multiple affected members have been reported, no genetic cause has been identified.

Several possible causes have been suggested, but none have been confirmed. These include infections, swelling (inflammation), traumatic events, or changes in the deposition and breakdown of fat (adipose tissue metabolism). Changes or abnormalities in the nervous system, immune system, or hormone production have also been proposed.

Inheritance

Most cases are sporadic, occurring in individuals with no family history of the disorder.

A small number of familial cases have been reported. When the condition runs in families, it appears to have an unknown pattern of inheritance.

Other Names for This Condition

  • Adiposalgia
  • Adipose tissue rheumatism
  • Dercum disease
  • Lipomatosis dolorosa
  • Morbus Dercum

Additional Information & Resources

Genetic and Rare Diseases Information Center

  • Adiposis dolorosa

Patient Support and Advocacy Resources

  • National Organization for Rare Disorders (NORD)

Clinical Trials

  • ClinicalTrials.gov

Catalog of Genes and Diseases from OMIM

  • ADIPOSIS DOLOROSA

Scientific Articles on PubMed

  • PubMed

References

  • Campen R, Mankin H, Louis DN, Hirano M, Maccollin M. Familial occurrence of adiposis dolorosa. J Am Acad Dermatol. 2001 Jan;44(1):132-6. doi:10.1067/mjd.2001.110872. Citation on PubMed
  • Dupuis H, Lemaitre M, Jannin A, Douillard C, Espiard S, Vantyghem MC. Lipomatoses. Ann Endocrinol (Paris). 2024 Jun;85(3):231-247. doi:10.1016/j.ando.2024.05.003. Epub 2024 Jun 12. Citation on PubMed
  • Hansson E, Svensson H, Brorson H. Depression in Dercum's disease and in obesity: a case control study. BMC Psychiatry. 2012 Jul 3;12:74. doi:10.1186/1471-244X-12-74. Citation on PubMed or Free article on PubMed Central
  • Hansson E, Svensson H, Brorson H. Review of Dercum's disease and proposal of diagnostic criteria, diagnostic methods, classification and management. Orphanet J Rare Dis. 2012 Apr 30;7:23. doi: 10.1186/1750-1172-7-23. Citation on PubMed or Free article on PubMed Central
  • Herbst KL. Rare adipose disorders (RADs) masquerading as obesity. Acta Pharmacol Sin. 2012 Feb;33(2):155-72. doi: 10.1038/aps.2011.153. Citation on PubMed or Free article on PubMed Central
  • Lemaitre M, Aubert S, Chevalier B, Jannin A, Bourry J, Prevost G, Lefebvre H, Vantyghem MC. Rare Forms of Lipomatosis: Dercum's Disease and Roch-Leri Mesosomatous Lipomatosis. J Clin Med. 2021 Mar 21;10(6):1292. doi:10.3390/jcm10061292. Citation on PubMed
  • Lemaitre M, Chevalier B, Jannin A, Le Mapihan K, Boury S, Lion G, Labalette M, Vantyghem MC. Metabolic and immunological phenotype of rare lipomatoses: Dercum's disease and Roch-Leri mesosomatic lipomatosis. Orphanet J Rare Dis. 2021 Jun 29;16(1):290. doi: 10.1186/s13023-021-01920-3. Citation on PubMed
  • Thiriveedi M, Gross GP. Adiposis Dolorosa. 2025 Nov 7. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507867/ Citation on PubMed
  • Tins BJ, Matthews C, Haddaway M, Cassar-Pullicino VN, Lalam R, Singh J, Tyrrell PN. Adiposis dolorosa (Dercum's disease): MRI and ultrasound appearances. Clin Radiol. 2013 Oct;68(10):1047-53. doi: 10.1016/j.crad.2013.05.004. Epub 2013 Jun 25. Citation on PubMed
  • Wortham NC, Tomlinson IP. Dercum's disease. Skinmed. 2005 May-Jun;4(3):157-62; quiz 163-4. doi: 10.1111/j.1540-9740.2005.03675.x. Citation on PubMed
  • Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol. 2007 Jun;56(6):901-16; quiz 917-20. doi: 10.1016/j.jaad.2006.12.004. Citation on PubMed

Frequently Asked Questions

lthough the exact cause is unknown, weight loss has been reported to alleviate symptoms in some patients, likely by reducing the mechanical pressure on the fatty tissue and associated nerves. A balanced, calorie-controlled diet combined with low-impact exercise is generally recommended. However, it is important to note that weight loss does not cure the condition, and pain management may still require pharmacological intervention. Patients should work with a healthcare provider to develop a sustainable plan that addresses both weight management and pain control.
While regular lipomas are usually painless and isolated, adiposis dolorosa involves multiple painful lipomas accompanied by systemic symptoms such as fatigue, depression, and sensitivity to cold or stress. Diagnosis is primarily clinical, based on the presence of painful subcutaneous nodules in a characteristic distribution (torso, limbs) and the exclusion of other conditions like fibromyalgia or rheumatoid arthritis. Biopsies are rarely needed unless the nodules have atypical features, but they can help rule out other soft tissue tumors.
There is no single cure, so treatment is often multimodal. Pain management may include non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or prescription pain relievers. In some cases, antidepressants or anticonvulsants are used to help modulate nerve pain. Physical therapy can improve mobility and reduce muscle tension. For localized, severe pain, corticosteroid injections into the lipomas may provide temporary relief. Surgical removal of individual lipomas is an option but is often not recommended as a primary treatment because new lipomas can develop elsewhere, and surgery may not resolve the widespread systemic pain.
Yes, many patients report that stress, anxiety, and emotional distress can exacerbate their pain and fatigue. The condition is often associated with mood disorders such as depression, which can create a cycle where pain leads to stress, and stress worsens pain. Mind-body techniques such as cognitive-behavioral therapy (CBT), mindfulness, and relaxation exercises may help manage the emotional component of the disease and potentially reduce the perception of pain. It is important to address both the physical and psychological aspects of the condition for comprehensive care.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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