Fibromyalgia Action UK

The Day After the Atos appointment!

Morning guys x Atos appt went well I think, very nice lady. Showed her pics of my fibrous lumps and was feeling like shit anyway. Felt exhausted yesterday and still feel exhausted today after all the stress and questions thrown at me. Everything I told her was how I felt on my bad days, so fingers crossed. Hope you are all having a good day today. Xx

5 Replies

Everyone is finding these atos appointments a nightmare - no wonder you're stressed and exhausted. I hope it all turns out OK for you, and that you feel better soon! :)

Moffy x



What are fibrous lumps?

I have lumps on the side of my fingers and a bump on my ankle is this due to fibro?



Some people attribute these lumps to “stuck” superficial fascia. Superficial fascia is attached to the underside of your skin. Capillary channels and lymph vessels run through this layer, and so do many nerves. The subcutaneous fat is attached to it. If your superficial fascia is healthy, your skin can move fluidly over the surface of your muscles. In FMS and CMP, it is often stuck.

Another explanation for these lumps is a condition called Dercum’s disease.

Diagnosis requires a history of at least three months of chronic pain in fatty tissue, either constant or recurring. Some articles add (1) generalized obesity, which is not always present (2) asthenia (loss of strength) and excessive fatigue and (3) mental disturbances, including depression, confusion, emotional instability, epilepsy, and dementia. Many people with Dercum’s report depression, occasional confusion (often called “brainfog”) and memory problems. Fortunately epilepsy and dementia seem to be quite rare. Much of the literature reports that Dercum’s occurs most often in obese postmenopausal women. However, it does occur in teenagers and young adults, and about one in twenty patients are male. While weight gain is common, there are many people with Dercum's who have never been overweight. Losing weight will not decrease the pain or the size of the lumps.

Other diseases which may be confused with Dercum’s include familial multiple lipomatosis, which is an inherited condition of usually non-painful lipomas, lipodystrophy, and Madelung’s disease (also known as multiple symmetric lipomatosis, among other names). In those conditions some lipomas (abnormal growth of fatty tissue) may be painful because they press on nerves, but most are not. In Dercum’s disease most or all lipomas and other fat deposits are tender or painful, with the pain often increasing over the space of years. In particular, bumping a Dercum’s lump or lipoma usually hurts, and pinching one usually hurts a lot, much more than one would expect. Sometimes lipomas in Dercum’s are angiolipomas - lipomas which contain many blood vessels.

Painful fat can occur anywhere on the body, including the head and neck. Some people have tender or painful fat deposits literally from the top of their head to the soles of their feet. They are almost always in the subcutaneous fat layer, although it seems that at times they can invade other tissues. It appears that not a lot is known about how often that happens.

Dercum’s has been classified into three types, based on the location and character of the painful fatty tissue. One can have a mixture of two types, such as type 2 and type 3. These are:

Type I, or the juxta-articular type, with painful folds of fat on the inside of the knees and/or on the hips, in rare cases only evident in upper-arm fat.

Type II, or the diffuse, generalized type, where widespread pain from fatty tissue is found, apart from that of type I, also often in the dorsal upper-arm fat, in the axillary (armpit)and gluteal (buttocks) fat, in the stomach wall, in dorsal (side) fat folds, and on the soles of the feet. This is the most common type. The painful fat can be spread out to resemble ordinary obesity at first glance, and can also occur as distinct lumps arising from the subcutaneous fat.

Type III, or the lipomatosis, nodular type, with intense pain in and around multiple lipomas, sometimes in the absence of general obesity; lipomas are approximately 0.5-4 cm, soft, and attached to the surrounding tissue.

Many patients with type III Dercum's report small rubbery nodules, which feel rather like corn or marbles under the skin. These often grow together into chains or clumps of lumps. These seem to occur most often in the arms, abdomen, and rib area.

The pain from Dercum’s disease is often described as aching, burning or stabbing. Pain is common when a lipoma is bumped, pressed, or pinched, but can occur at any time. Sometimes even the lightest pressure can be painful, and only loose clothing can be tolerated. Pain can also be felt in the skeleton, as well as the fatty tissues.

The intensity of the pain varies from mild discomfort to excruciating pain. Pain often increases during menstruation, and decreases with warmth and high barometric pressure. Infections often make the pain worse. Stress, both physical and psychological, appears to make the symptoms of Dercum’s worse. Unfortunately, just having Dercum’s disease adds a lot of stress to life.

Other problems which commonly occur with Dercum’s disease include the following.

Swellings that appear and often recede for no apparent reason. The swellings can resemble retained water, but they are non-pitting. That is, firm pressure by a thumb doesn't cause a pit that slowly becomes level. These swellings can leave the skin loose and inelastic (saggy skin, or pendulous skin folds), or hardened. In some cases it appears that as or after the swellings subside, adipose tissue (fat) increases under the skin, and at times nodular lipomas can be felt later.

Sleep disturbances and difficulty getting to sleep are common. Many patients find they need ten or more hours of sleep each day to function. Missing sleep can make the pain worse, and more pain makes sleep even more difficult.

Numbness, tingling and burning in the limbs, particularly the hands and feet. This seems to occur when a lipoma presses on a nerve. It can be constant or only noticed when the limb is in certain positions. It can disappear without treatment at times, presumably when temporary swelling is putting additional pressure on the area. This seems to be relatively rare, however. In most cases it won’t subside without removal of the offending lipomas.

Thyroid problems may occur. This is most commonly an underactive thyroid, but overactive thyroid has also been noted.

Other problems are also reported, such as fibromyalgia, carpal tunnel syndrome, tendonitis, irritable bowel, and pain in the tailbone and vulva.

It is very rare that cancers of the fatty tissue (liposarcomas) start in an existing lipoma. There doesn’t appear to be any higher chance of developing cancer because one has Dercum’s disease.

No one knows what causes Dercum’s disease, but it appears to be hereditary in some families. From the way it seems to be transmitted in those families, there is a single gene that mutates.

It could also be arthritis.

1 like

Ihave big lumps inside my elbows im wondering if this is to do with fibro x


my atos appointment made me feel awful.A bad flare up especially after a 3 hour wait and then an assessment


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