Pain, Central Sensitization, and Misophonia in Lipedema

Lipedema is a chronic condition that predominantly affects women and is characterized by disproportionate, usually symmetrical accumulation of subcutaneous fat, particularly in the hips and legs. Pain, tenderness, easy bruising, fatigue, and psychological symptoms may substantially affect daily functioning and quality of life. Misophonia involves intense negative reactions to specific sounds, but its relationship with lipedema remains unclear. This observational case-control study aims to investigate misophonia symptoms in women with lipedema compared with women without lipedema and to explore their associations with pain and psychosocial factors. The prespecified primary outcome measure is central sensitization severity, assessed using the Central Sensitization Inventory. Secondary outcome measures include misophonia symptom severity, pain intensity, pressure pain thresholds, pain catastrophizing, sleep quality, depressive and anxiety symptoms, and body image. The study will compare these outcomes between groups and examine their associations with misophonia symptoms.

Inclusion Criteria: * Female sex. * Age 18-65 years. * Case group: Clinical diagnosis of lipedema based on medical history and physical examination, and a Lipedema Screening Questionnaire score of ≥9. * Control group: No clinical diagnosis of lipedema based on medical history and physical examination, and a Lipedema Screening Questionnaire score of \