Can acoustic wave therapy (AWT) cure lipedema? - Advanced cellulite and skin tightening treatments in London, by LipoTherapeia Book a treatment at LipoTherapeia

Can acoustic wave therapy (AWT) cure lipedema?

Acoustic wave therapy for lipoedema: an analysis

Does acoustic wave therapy (AWT) work for lipedema?

A few weeks ago we had a question by a website visitor :

“Thank you for your ‘Acoustic wave therapy for cellulite: does it work?’ page. What about lipedema (lipoedema)? If it doesn't work on soft fat, what about the hard fat that forms from lipedema? I have lipoedema, as do 1/10 women. I'm not sure what stage, as doctors don't know much about it. Just wondering if you have tried AWT on lipedema, as there is no research so far.”

I have to say this is a very smart question and (unless ones has specifically studied the anatomy of adipose tissue and the science of AWT) makes a lot of sense. However, the devil is always in the detail. So let’s look at the detail then.

Acoustic wave therapy (AWT) (aka extracorporeal shockwave therapy (ESWT) or shockwaves) to treat tendons, ligaments and bone

Acoustic wave therapy (AWT), known in physiotherapy as ‘extracorporeal shockwave therapy’ (ESWT) or simply ‘shockwaves’, is a treatment for bone and tendon injuries and malfunction.

It is basically a controlled hammer that hits tissues at typically between 2-20 times a second with the aim to cause micro-injury and consequent healing or to break down scar/fibrotic tissue.

As with all hammers, AWT works well when applied on hard tissue, such as bone, ligament, fascia or tendon. Trying to apply it on soft tissues, as in fat tissue or cellulite is like trying to hammer a pillow or a balloon: nothing will happen.

Acoustic wave therapy for cellulite? It doesn’t work

This of course hasn’t stopped people from applying ESWT / AWT on cellulite, given that cellulite is more fibrotic than plain subcutaneous fat. Well, sure, cellulite is more fibrotic, and therefore harder, than normal fat. But it is still not nearly as hard as a tendon, a ligament or, especially, a bone.

We have researched AWT and worked on it with three high-end machines a good 20 years ago (way before all the pointless ‘AWT for cellulite’ hype got started by a crafty PR agent working for a crafty med spa) and we found it lacking. So we dropped AWT and have written all about it here.

Sure, the med spa made millions out of AWT for cellulite (as they made from lots of other hype that they pushed on gullible people), people got misled and achieved poor results and we chose to be honest and make no money by misleading people.

Oh well…

No, fat tissue is not that fibrotic and acoustic wave therapy does not work for lipedema either

So based on the fact that lipedema is more fibrotic than plain fat, our website visitor had the idea that perhaps AWT can “work” on lipedema, meaning that perhaps acoustic wave therapy can reduce lipedema.

However, although lipedema has a higher amount of collagen than normal fat (calculated to be about 0.5%-0.8% versus 0.2% for subcutaneous fat and 0.3% for the generally more fibrotic visceral fat), this still does not qualify lipedema as a hard tissue where AWT could work well.

Tendons, for example, have around 20%-30% collagen, i.e. they are about 30-40x more “fibrotic” (collagenous) than lipedema, so AWT has no chance in working effectively to reduce lipedema. It is literally like hitting a pillow with a hammer, which is exactly the same when you work on cellulite - or any fat tissue - with AWT.

And bones, were AWT shines, are even harder than tendons and ligaments.

Fat tissue is 400,000 times softer than a tendon

In addition to considering collagen content we can actually go a bit further and consider how hard those tissues are. The harder the tissue the more AWT is suitable to treat them. This hardness can be measured by the tissue’s Young's modulus.

Now, Young's modulus* values are:

Seeing that fat tissue is anything between ten thousand times to 7 million times softer than the tissues for which AWT was developed for, shows the fallacy of trying to treat cellulite, lipedema or any other fat tissue with AWT: it is just not that suitable, and consequently, effective or efficient.

Can acoustic wave therapy help improve lipedema symptoms?

Now, if the question is ‘Can AWT help improve circulation and reduce the symptoms of lipedema, such as pain and heaviness?” then the answer is that most probably it can.

But normal deep tissue massage, strong cellulite-style massage, ultrasound, radiofrequency and even infrared light therapy have also been proven to help relieve the symptoms of lipedema.

(We already offer the last three treatments, radiofrequency, ultrasound and near-infrared light therapy to lipedema sufferers, with great results in terms of improving leg heaviness and discomfort. But we never claim we can cure lipedema.)

So AWT can perhaps be added to the list.

For lipedema, surgery is the only option

However, under no circumstances should one promote AWT as a “lipedema cure” or a even an effective lipedema reduction therapy. That would be misleading, to say the least.

At the moment, the only true lipedema reduction treatment is lipoedema liposuction. Nothing else really works.

Sure, we can definitely improve the symptoms of lipedema, lipedema sufferers’ quality of life and even lipedema progression with super-healthy eating, exercise, antioxidant/anti-inflammatory supplements and all the different treatments mentioned above.

But don’t expect reduction or cure, as it is not going to happen. Let’s be honest.

Young’s modulus, fibrosis and acoustic wave therapy

* Young's modulus, also known as the elastic modulus, is a fundamental property of materials that measures their stiffness or resistance to elastic deformation under stress. It is defined as the ratio of longitudinal stress (force per unit area) to longitudinal strain (change in length per original length) within the elastic limit of a material.

Named after Thomas Young, this modulus is typically expressed in pascals (Pa) or gigapascals (GPa). It quantifies how much a material will stretch or compress under tension or compression, providing insight into its mechanical behavior.

For example, steel has a high Young's modulus, indicating greater stiffness, while rubber has a low value, reflecting flexibility.

** AWT output strength is also measured in megapascals, MPa:

  • Low-intensity ESWT produce peak pressures in the range of 1–10 MPa

  • High-intensity ESWT, such as that used in lithotripsy (breaking kidney stones), can reach 20–100 MPa or more

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