Physiotherapy and Motherhood: Practical Support for Mothers with Rheumatic Diseases

What are rheumatic diseases?

Rheumatic diseases include a wide group of disorders that affect muscles, joints, tendons, and in some cases, even the immune system. The most common autoimmune and inflammatory conditions include: Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), and Sjögren’s Syndrome, among many others.
These conditions can cause several symptoms, such as:

• Joint pain and stiffness;
• Swelling and difficulty moving;
• Severe fatigue;
• Weight loss;
• General feeling of malaise.

Other symptoms, more closely related to specific conditions, may include:

• Skin rashes;
• Dry eyes and mouth;
• Raynaud’s phenomenon (fingers turning white or purple in the cold);
• Respiratory problems or eye inflammation.

Rheumatism and pregnancy: what are the risks?

Many women with a rheumatic disease wonder if they can go through pregnancy. The answer is, of course, yes—although some precautions must be considered. These concern risk factors that can affect both the progression of the disease and the course of pregnancy:

• Fertility: some conditions, such as rheumatoid arthritis, may slow down conception.
• Medication: some treatments can affect fertility or fetal development. It is essential to discuss this with your doctor and gynecologist.
• Course of the disease: during pregnancy, some conditions may improve, remain stable, or flare up. For example, rheumatoid arthritis may improve, while lupus may worsen.
• Possible complications: there is a slightly increased risk of preterm birth, low birth weight, or, in rare cases, heart problems in the newborn.
• Adverse events: miscarriages or fetal death, although rare, are possible, especially if the disease is not well controlled.

Becoming a mother is an extraordinary experience, but it can also be challenging—especially for women living with an inflammatory rheumatic disease, such as rheumatoid arthritis. In this journey, the physiotherapist can provide valuable support to the couple.

How can the physiotherapist help an expectant mother with rheumatic diseases?

During pregnancy, the body changes, and these changes add to the symptoms of the disease. The physiotherapist helps to:

• Reduce pain and fatigue;
• Avoid joint overload;
• Maintain independence in daily activities;
• Prepare for newborn care safely;
• Support psychological well-being.

Practical interventions by the physiotherapist

Thanks to a holistic approach to patient care, physiotherapists use several strategies:

1. Education and self-management of the disease

   • Techniques for joint protection;
   • Management of chronic pain and fatigue (e.g., alternating rest and activity);
   • Correct postures for sleeping, sitting, or lifting objects;
   • Support in managing stress and anxiety.

2. Adapting daily activities

   • Strategies for dressing, cooking, and bathing more easily and safely;
   • Use of assistive devices that reduce effort (ergonomic bottle openers, adapted kitchen tools, shower seats…);
   • Planning meals, shopping, and cleaning to avoid fatigue.

3. Ergonomics during pregnancy

   • Education on safe movement, even with unstable joints;
   • Advice on how to move, lift, and bend correctly;

4. Therapeutic exercise

   • Gentle movements to maintain muscle flexibility;
   • Low-impact exercises such as stretching, yoga, and water-based activities;
   • Strengthening exercises with free weights and/or gym machines.

5. Preparation for newborn care

   • Training in the use of changing tables, cribs, ergonomic baby carriers;
   • Techniques for holding and moving the baby safely and without pain;
   • Choosing teats and bottles that are easy to open.

6. Environmental adaptations

   • Home assessment to improve accessibility;
   • Small modifications that make a big difference in daily life.

7. Joint protection and energy-saving strategies

   The therapist teaches how to divide tasks, organize activities, avoid unnecessary strain, and use equipment that lightens the load on painful joints.
   These strategies help reduce pain and inflammation, limit fatigue, and preserve joint function over time.

In conclusion, is a peaceful pregnancy possible?

Absolutely yes!
With proper pre-conception planning, continuous monitoring, and a personalized therapeutic plan—and thanks to the collaboration of an interdisciplinary team—many women with rheumatic diseases experience pregnancy without complications and in complete peace of mind.