Pain & weakness from Dercum’s Disease (adiposis dolorosa) is often attributed to lipomas (fatty deposits) applying pressure to nerves. This explanation is included in many definitions of the disease [1,2,3]. This theory has not been confirmed histopathologically in patients with Dercum’s Disease. However, nerve compression secondary to adjacent lipomas is a recognized medical condition[5,6,7]. Most lipomas are asymptomatic, but they can cause pain when they compress nerves. In fact, neuropathic pain related to subcutaneous lipoma without direct nerve compression is possible. Lipomas exhibit a different cytokine profile than normal adipose, which may contribute to neural inflammation or microvascular changes.