What are rheumatic diseases?
Rheumatic diseases include a wide group of disorders that affect muscles, joints, tendons and, in some cases, the immune system. The most common autoimmune and inflammatory types include Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA) and Sjögren’s Syndrome, among others.
These conditions may cause a variety of symptoms, such as:
Joint pain and stiffness
Swelling and difficulty moving
Intense fatigue
Weight loss
A general feeling of being unwell
Other symptoms, which depend on the specific disease, may include:
Skin rashes
Dry eyes and mouth
Raynaud’s phenomenon (fingers turning white or bluish in the cold)
Respiratory issues or inflammation of the eyes
Rheumatic diseases and pregnancy: what are the risks?
Many women with a rheumatic disease wonder whether they can have a pregnancy. The answer is yes, although some important considerations are required. These relate to risk factors that may affect both the course of the disease and the pregnancy itself:
Fertility: some conditions, such as rheumatoid arthritis, may make it harder to conceive.
Medication: some treatments may affect fertility or foetal development. It is essential to discuss this with both the rheumatologist and the gynaecologist.
Course of the disease: during pregnancy, some conditions may improve, remain stable, or flare up. For example, rheumatoid arthritis may improve, whereas lupus can worsen.
Possible complications: there is a slightly increased risk of preterm birth, low birth weight or, rarely, congenital heart problems in the baby.
Adverse events: miscarriage or stillbirth, though rare, can occur especially if the disease is not well controlled.
Becoming a mother is an extraordinary experience but can be demanding — particularly for women living with an inflammatory rheumatic condition such as rheumatoid arthritis. In this journey, the physiotherapist can play an important supportive role for the couple.
How can a physiotherapist support a pregnant woman with rheumatic disease?
During pregnancy, the body undergoes many changes, which can add to the symptoms of the disease. Physiotherapists can help to:
Reduce pain and fatigue
Prevent joint overload
Maintain independence in daily activities
Prepare for safe newborn care
Support psychological wellbeing
Practical physiotherapy interventions
Thanks to their holistic approach, physiotherapists can use a variety of interventions:
1. Education and self-management
Techniques to protect the joints
Managing chronic pain and fatigue (e.g. alternating rest and activity)
Correct postures for sleeping, sitting and lifting objects
Support with stress and anxiety management
2. Adapting daily activities
Strategies to make dressing, cooking and washing easier and safer
Use of aids to reduce effort (e.g. ergonomic jar openers, adapted kitchen tools, shower seats)
Planning meals, shopping and housework to avoid fatigue
3. Ergonomics during pregnancy
Education on safe movement, even with unstable joints
Advice on safe lifting, bending and posture
4. Therapeutic exercise
Gentle movements to maintain muscle flexibility
Low-impact exercises such as stretching, yoga, or water-based exercise
Strengthening exercises with free weights or gym equipment
5. Preparing for newborn care
Training on how to use changing tables, cots and ergonomic baby carriers
Techniques for holding and moving the baby safely and without pain
Choosing bottles and teats that are easy to open
6. Environmental adaptations
Assessing the home to improve accessibility
Making small modifications that can make everyday life easier
7. Joint protection and energy conservation strategies
Teaching how to divide tasks, organise activities, avoid unnecessary strain and use equipment that reduces stress on painful joints
These strategies help to relieve pain and inflammation, reduce fatigue, and preserve joint function over time.
Can women with rheumatic diseases have a calm and healthy pregnancy?
Absolutely yes!
With good pre-conception planning, regular monitoring, and a personalised treatment plan, and thanks to collaboration with an interdisciplinary team, many women with rheumatic diseases experience pregnancy without complications and in complete serenity.
