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Painful nodes

Painful nodes or lumps under the skin are a problem that affects many people, and usually for several different reasons. These lumps are often not a disease per se, and they are rather a symptom of an underlying condition.


Fibromyalgia is a disorder with many different symptoms, including muscle and connective tissue pain. One symptom of this disorder, which is not widely commented in textbooks, is the presence of painful lumps under the skin.

Some attribute these lumps to superficial fascia that gets stuck. Superficial fascia is found underneath the skin. Lymph vessels, capillary channels and nerves run through it and subcutaneous fat, meaning fat just beneath the skin, is attached to it. In fibromyalgia it can get stuck and the skin does not flow normally and fluidly over the muscles.

Dercum’s disease

Dercum’s disease or adiposis dolorosa is another possible explanation for the lumps beneath the skin, called lipomas. Lipomas are composed of fatty tissue. This disease includes pain in fatty tissue, often with weight gain, fatigue, loss of stamina, and mental disturbances including depression, anxiety, confusion, and dementia.

It mostly affects overweight women, especially in postmenopausal age.

Some diseases can be confused with Dercum’s. those are multiple lipomatosis, lipodystrophy and Madelung’s disease. However, in these diseases the lipomas may cause pain if they press on the nerves, but otherwise they are painless, while lipomas caused by Dercum’s disease are tender or painful. The pain increases when they are bumped, and if they are squeezed or pinched they hurt a lot.

In this disease the lumps may form in all parts of the body, and in some cases they can virtually be present anywhere from head to toe.

Usually they affect the subcutaneous fat layers although they are known to affect other tissues as well.

The pain is described as stabbing, aching or burning. It can range from mild discomfort to excruciating pain. In women, the pain gets worse during menstruation and lessens with warm weather and high pressure. If the lumps get infected, the pain gets worse. Also, the pain increases with stress and anxiety levels.

Other problem associated with this disease is swelling, which can be confused with water retention. However, unlike water retention, these swellings do not pit when pressed with a thumb. When the swelling recedes, it leaves the sagging skin.

Other symptoms of Dercum’s disease include sleep disturbance, tingling, numbness and burning sensation in the limbs.

The exact cause of Dercum’s disease is yet unknown but it is believed to be hereditary.

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