Treatment Approaches

Someone with lipedema may want to work on purely physical problems - pain, swelling, heaviness, trouble walking, and so on. That person’s goal might be less pain and walking more easily.

In that case, we would likely decide that manual lymphatic drainage is the best approach, since there’s substantial evidence to show that it relieves swelling and pain in lipedema. Visits may incorporate somatic therapies or other bodywork modalities as other issues are brought up - for instance, body acceptance, nervous system regulation, and coping with an overwhelming world are common needs.

So visits might be mostly manual lymphatic drainage, but elements of somatic bodywork or craniosacral therapy might also be mixed in.

There’s a broad spectrum of what a neurospicy person might want to work on. Someone who discovered their neurotype as an adult may have the goal of getting overwhelmed less often and functioning better at work, now that they have a new understanding of how their brain works.

With a goal of less overwhelm, we might start by learning more about how this individual’s brain works. We can look at interoception (the sense that tells us what’s happening inside the body), executive function (the skills that allow us to get things done), and/or sensory sensitivities. We may also talk about what helps them feel better, and what things take more effort.

These visits will probably be a lot of talking and some practicing skills. We would come up with ideas together, and fine tune those ideas in later sessions. As we get more specific ideas of what helps, we may decide to incorporate other treatment approaches as well.

Many people don’t just have one chronic condition. Someone with EDS may also have POTS, MCAS, and digestion problems, and come in with a general goal of less pain and fatigue.

For that person, I might mix and match various bodywork approaches, listening to what the body needs on that day. We could use lymphatic drainage for inflammation and circulation, visceral manipulation to help move the digestion, and craniosacral therapy for an autonomic nervous system reset (just as an example).

We might also spend time talking about how to pace themself better, so they can manage their unpredictable energy. We may use somatic therapies to work with the grief of a new disability or work through the medical trauma of being gaslit for so long. Or we may rant together about the challenges of surviving capitalism!

Burnout happens when too much is demanded of us for too long, without the needed time to recover. Moral injury is added on top of it when we don’t have the power to do the right thing. Activists, healthcare workers, people experiencing oppression, and everyone trying to make the world better are particularly vulnerable. Recognizing that these are systemic problems, an individual might have a goal of being able to keep going.

For this person, we will likely take a somatic approach. We may find ways to access pockets of rest and safety, no matter how small. We may work on listening to the body instead of overriding its messages. We may work on helping the nervous system get regulated and expanding its capacity. We may look for changes that the individual can make so their life can be more sustainable.

Visits might be talk-only in the office or online, might include movement or self-touch, or might include somatic bodywork and therapeutic touch.

Someone who has gone through cancer treatment, or is still in the midst of it, may have twin goals of managing the physical changes and coping with the emotional impact.

Various forms of bodywork can be effective for the physical effects. Manual lymphatic drainage is great for lymphedema treatment/prevention, neurolymphatic drainage is good for brain fog and chemo recovery, and myofascial release can help with restrictions from surgical scars. Bodywork can also help the body reset the nervous system so it can regulate and recover.

Somatic therapy can also be useful. Whether talk-based or bodywork, we can process through the trauma that almost all of us experience when facing our mortality. We can also work with befriending a changed body and the fear of recurrence.