Lipoatrophy & Sitting Pain Background
Lipoatrophy is the loss of subcutaneous fat and occurs in three main patient populations, HIV/AIDS, cancer and seniors. Loss of fat in the buttocks leads to sitting pain and suffering resulting in the discontinuation of many activities that contribute to the quality of life.
AIDS Background
The Center for Disease Control estimates there are 1,000,000 persons with HIV/AIDS in the U.S. Lipodystrophy/lipoatrophy, peripheral fat wasting of the extremities, and sarcopenia, muscle wasting, will be experienced by an estimated 64% of the treated demographic. Some HIV researchers believe 100% of the affected and treated HIV population will eventually experience some degree of fat and muscle wasting if current drug regimens are continued over many years.
Body changes due to lipoatrophy and muscle wasting are the most difficult to treat of the metabolic complications associated with HIV and appear to be exacerbated by HAART (Highly Aggressive Anti-Retroviral Therapy). The loss of normal fat and muscle in the buttocks and upper legs leads to crushed nerves and extreme pain upon sitting. This has a negative impact on physical and psychosocial well-being in social and work situations, contributes to social stigmatization and easy identification as HIV+ and often leads to depression and anxiety, erosion of self-image and self-esteem.
Many patients adjust to the limitations of lipoatrophy in the interest of survival. Some, however, lose interest in complying with complex drug regimens, which eventually leads them to discontinue medications and lose of control of their HIV infection.
Many HIV/AIDS patients experiencing peripheral fat and muscle wasting in the legs and buttocks withdraw from social situations that involve or require sitting. A pattern of sustained avoidance of social and work interactions, which are vital to psychological health, negatively affect the quality of life of an HIV/AIDS patient who is trying to stay active and engaged in normal activities while staying in compliance with a HAART drug regimen. Similarly, HIV/AIDS patients who experience severe “peripheral fat and muscle wasting” often complain that clothing, doesn’t fit well and try to avoid participation in public occasions where emphasis is placed on appearance and attire.
Some HIV physicians prescribe pain medications for the pain experienced due to normal sitting. When muscle wasting accompanies lipoatrophy, some physicians recommend human growth hormone or anabolic steroids in an effort to build additional muscle tissue to compensate for fat depletion. Both therapies are expensive, have undesirable side effects for HIV patients and are not well covered by insurance providers.
Determined patients report trying weight gain supplements and powdered nutritional formulas in an effort to boost subcutaneous fat throughout the body. These supplements do not reverse the fat depletion resulting from HAART induced lipoatrophy.
After exhausting possible nutritional solutions to the fat and muscle-wasting syndrome, some patients explore plastic surgery as a palliative option. The cost is prohibitive for most of this affected demographic and not typically covered by health insurance. Research has reported death, disease and extremely unsatisfactory outcomes among patients seeking unrealistic solutions from physicians with limited training in these high-risk medical interventions.
Currently, HIV/AIDS patients with moderate to extreme fat and muscle of the hips and buttocks, who are seeking to engage in normal social and work related activities, are faced with the following options: Withdrawal or limitation of desirable activities, use of pain medications, hormone therapies, plastic surgery or carrying a cushion into public venues.
Carrying cushions in meetings, theaters, restaurants and automobiles and other public and work places is inconvenient and stigmatizes the user as “unhealthy” or “has a problem”. Consequently, many patients ultimately withdraw from normal activities which contribute to a higher quality of life.
Seniors Background
The 2004 U.S. Census estimates there are 35 million Americans 65 years of age or older. The number of people 65 years and older will double during the next 30 years. According to the National Institute on Aging, by the time most (healthy) people reach 70 years of age they have lost 20 to 40 percent of muscle tissue. Cancer and other conditions can accelerate this loss. This commonly leads to sitting pain.
As with HIV patients, carrying cushions in meetings, theaters, restaurants and automobiles and other public and work places is inconvenient and stigmatizes the user as “unhealthy” or “has a problem”. Consequently, many seniors ultimately withdraw from normal activities which contribute to a higher quality of life.
Cancer Background
An estimated 11 million Americans are living with cancer. Fifty percent have significant weight loss and are candidates for sitting pain relief. The inconvenience of carrying cushions noted for HIV and seniors applies to cancer patients as well.
Anatomy of Sitting Pain
To understand the anatomy of the area and origin of sitting pain, the following shows the major nerves in the pelvis and buttocks.
Major Nerves in the Buttocks
Looking from the back at the pelvis, the sciatic nerve passes over the pelvic bones beneath the buttocks muscles and down the back of the leg. Other nerves in the area are noted as well.
Lateral View Normal Padding Provided by Buttocks Muscle and Fat
In this side view of the human pelvis cut thru the hip joint, the small white arrows indicate the sciatic nerve, which is usually well padded by the buttocks muscle and fat seen above on the right. In lipoatrophy and sarcopenia patients, i.e. AIDS, seniors and cancer patients, this muscle and fat pad is dramatically reduced resulting in the nerve being crushed against the pelvic bones when sitting causing significant pain.
Contact Information
Joe Bollert, PhD
Co-founder
LipoWear, LLC
2102 Business Center Dr.
Irvine, CA 92612 USA
info@lipowear.com
Phone: 1-714-323-2116
Fax: 1-413-410-0120
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