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Systemic Lupus Erythematosus (SLE) is the most common type of Lupus. SLE is an autoimmune disorder in which the immune system mistakenly attacks healthy tissues. This can result in pain, inflammation and damage to various tissues/organs within the body. It is most commonly seen in women of childbearing age and the severity can vary widely on a case-by-case basis.

Signs and Symptoms

SLE is known to have a range of symptoms that can either present sporadically in “flare-ups”, or be more persistent in nature. These symptoms include the following:

• Fatigue
• Joint pain and swelling
• Rash/Skin sensitivity: This is often exacerbated by exposure to direct sunlight and is commonly manifested in what is described as a “butterfly rash across the face”
• Loss of appetite and weight loss
• Fever
• Muscle weakness
• Chest pain or shortness of breath: Due to inflammation in the lungs or heart lining.
• Kidney issues: Swelling in the legs or around the eyes, and changes in urine colour or frequency.
• Neurological symptoms: Headaches, confusion, memory problems, or seizures.

Diagnosis

As seen above SLE can present with a wide range of symptoms, hence mimicking other conditions and making diagnosis challenging at times. That being said early diagnosis is important and consultation with your medical team can help start this process.

Diagnosis is based on the presentation of clinical signs and confirmed with further testing, including blood tests. A blood test will involve Anti-Nuclear Antibody (ANA) testing in which the presence of antibodies that may attack healthy tissues in the body is assessed.

Causes

Unfortunately, we are yet to determine the exact cause of SLE but we believe it to be a result of a combination of genetic, hormonal and environmental factors including;

• Genetics: Family history is an indicator of increased risk
• Hormones: Oestrogen is thought to play a role, as SLE is more common in women.
• Environmental triggers: Exposure to sunlight, infections, stress, or certain medications.

Prognosis

It is important to note that the nature of this condition is chronic and at times can be unpredictable, with periods of flare-ups and remission (periods of time where symptoms improve).

That being said the prognosis for people living with SLE has improved significantly due to advances in medical treatment and early diagnosis. Most people with SLE can manage their symptoms and maintain a good quality of life.

Prognosis also depends on the severity of organ involvement, particularly in the kidneys and heart. Early detection and appropriate management are crucial for reducing complications and improving long-term outcomes. With ongoing treatment and lifestyle adjustments, many people with SLE lead active and fulfilling lives.

Treatment

Unfortunately, at this time there is no cure for SLE although there are a range of treatments that can help to manage symptoms and improve quality of life. Treatments may include medications such as;

• Nonsteroidal anti-inflammatory drugs (NSAIDs): To relieve pain and reduce inflammation.
• Corticosteroids: To control inflammation during flares.
• Immunosuppressants: To reduce overactivity of the immune system.
• Antimalarials: To manage skin and joint symptoms and reduce flare frequency.
• Biologic agents: For severe cases not responding to standard treatments.

Physiotherapy and Rehabilitation

Physiotherapy plays a crucial role in the management of SLE, particularly in maintaining mobility, reducing pain, and improving overall function. Physiotherapists can help by:

• Exercise programs: Tailored exercises to enhance muscle strength, joint flexibility, and cardiovascular fitness. Low-impact exercises, such as swimming, walking, and stretching, are particularly beneficial.
• Pain management techniques: Including heat and cold therapy, gentle manual therapy, and relaxation exercises to reduce muscle tension.
• Fatigue management: Developing pacing strategies and energy conservation techniques to help clients manage fatigue more effectively.
• Posture correction and ergonomic advice: To minimise joint strain during daily activities.
• Education and support: Helping clients understand their condition, recognise early signs of flares, and implement self-management strategies.

Additional Management Strategies

• Sun protection: Wearing sunscreen and protective clothing to avoid UV-triggered flares.
• Healthy diet and hydration: To support overall health and reduce inflammation.
• Stress management: Using relaxation techniques to minimise flare triggers.

Sources

Blaess, J., Goepfert, T., Geneton, S., Irenee, E., Gerard, H., Taesch, F., Sordet, C., & Arnaud, L. (2022). Benefits & risks of physical activity in patients with Systemic Lupus Erythematosus: a systematic review of the literature. Seminars in Arthritis and Rheumatism, 58, 152128. https://doi.org/10.1016/j.semarthrit.2022.152128

Branch, N. S. C. a. O. (2025, January 8). Systemic lupus erythematosus (Lupus). National Institute of Arthritis and Musculoskeletal and Skin Diseases. 

The Royal Australian College of general Practitioners. (n.d.). Systemic lupus erythmatosus. Australian Family Physician. https://www.racgp.org.au/afp/2013/october/systemic-lupus-erythmatosus

Systemic Lupus Erythematosus. (2023, August 4). National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK535405/

This exercise strengthens the glutes, hamstrings, and core while incorporating a calf activation element. The heel raise adds an extra challenge to stability and lower limb control. It’s useful for improving posterior chain strength, coordination, and endurance, particularly in rehabilitation settings or athletic conditioning.

Progression 1: Double-Leg

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
• Engage your core and press through your heels to lift your hips, creating a straight line from your shoulders to your knees.
• Once at the top, lift both heels off the ground, rising onto the balls of your feet.
• Lower your heels back down, then slowly return your hips to the floor.
• Complete repetitions as prescribed by your physiotherapist.

Progression 2: Double Leg with Maintained Heel Raise

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
• Lift your heels off the ground so you are on the ball of your foot before initiating the bridge.
• Engage your core and press through your heels to lift your hips, creating a straight line from your shoulders to your knees.
• Keep a strong, controlled movement as you lower back down, ensuring your heel stays off the floor.
• Complete repetitions as prescribed by your physiotherapist.

Progression 3: Single-Leg with Heel Raise

• Start lying on your back with one foot planted and the other leg extended.
• Engage your core and press through your heels to lift your hips, creating a straight line from your shoulders to your knees.
• Once at the top, lift the heels off the ground, rising onto the ball of your foot.
• Lower your heel back down, then slowly return your hips to the floor.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Letting the lower back arch excessively instead of engaging the glutes.
• Lifting the hips unevenly or letting them drop to one side (especially in the single-leg variations).
• Pushing through the toes instead of using the whole ball of the foot when raising the heel.
• Moving too quickly, leading to loss of control.

Progressions

To make the exercise more challenging, you can:

• Slow down the movement, increasing time under tension.
• Add a resistance band around the thighs for extra glute engagement.
• Hold a weight on your hips for additional resistance.
• Perform the exercise on an unstable surface, such as a foam pad or BOSU ball.

Regressions

To make the exercise easier, you can:

• Keep both feet flat on the floor throughout the movement.
• Reduce the height of the bridge to limit strain.
• Perform the movement without the heel raise to focus on basic glute activation.
• Support the movement by placing your hands on the floor for added stability.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Nerve sliders or neural ‘flossing’ provide an effective strategy to alleviate neural tension within the muscle interface that is passes through, without exacerbating symptoms. Discuss with your Physiotherapist which variation is appropriate for you dependent on the degree of neural tension.

Instructions

• Lying on your back, use a towel to help keep your leg in a comfortable 90 degree position with your ankle in neutral position.
• Straighten your knee, and let your ankle turn outwards
• Bend your knee back to 90 degrees and bring your ankle back to neutral
• Complete as per Physiotherapist guidelines

Precautions

• Perform this exercise strictly as guided by your physiotherapist – do not be tempted to perform more repetitions as this may irritate the tissue
• If your symptoms become aggravated, stop immediately and notify your physiotherapist

Side stepping without resistance is a fundamental exercise designed to improve balance, lower limb strength, and lateral stability. It targets the hip abductors, quadriceps, and core stabilisers, helping to enhance control during sideways movements. This exercise is often prescribed to improve mobility and falls prevention.

Instructions

• Stand tall with your feet hip-width apart. Maintain an upright posture with your shoulders relaxed.
• Place your hands on a stable surface for support e.g. kitchen bench or back of a couch.
• Step sideways with your leading foot, ensuring the movement comes from the hip rather than dragging the foot. Keep your toes pointing forward. 
• Follow with the trailing foot, returning to a stable stance.
• Continue stepping in one direction for the prescribed number of steps, then repeat in the opposite direction.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Taking steps that are too large, which may reduce control and balance.
• Twisting at the hips/torso instead of keeping a neutral posture.
• Dragging the trailing foot rather than actively lifting it.

Progressions

To make the exercise more challenging, you can:

• Take larger steps while maintaining control.
• Perform the exercise with a slight bend in the knee to engage more lower limb muscle. 
• Reduce hand support if balance allows by hovering your hands above a stable surface whilst performing the exercise or holding your hands on your hips.

Regressions

To make the exercise easier, you can:

• Take smaller steps to reduce balance demands.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Peak Physio now offers mobile and home visit physiotherapy services, bringing expert care directly to your home in Newcastle, Rutherford, Budgewoi, and surrounding areas. Whether you have mobility challenges, require post-surgery rehab, or simply prefer treatment in the comfort of your home, our experienced physiotherapists are here to help.

Why Choose Mobile Physiotherapy?

• Convenient & Accessible – No need to travel; we come to you.
• Personalised Treatment – One-on-one care tailored to your needs.
• Disability & Seniors Support – Ideal for those with disabilities or aged care needs.
• Post-Surgery Rehabilitation – Recover safely in a familiar environment, reducing stress and improving outcomes.
• Reduce Hospital Readmission – Physiotherapy can help prevent complications and re-injury.

Our Mobile Physiotherapy Services

Our team provides a wide range of treatments, including:

• General Physiotherapy – Pain management, injury recovery & movement improvement.
• NDIS Physiotherapy at Home – We offer in-home physiotherapy for NDIS participants, providing tailored treatment to support mobility, rehabilitation, and overall well-being.
• Pre & Post-Surgery Home Physio – Safe and effective physiotherapy at home after hip, knee, or back surgery.
• Seniors Exercise & Rehabilitation – Strength, balance & fall prevention.
• Vestibular Physiotherapy – Dizziness & vertigo treatment at home.

Mobile Physio Locations – Newcastle, Maitland, Central Coast & Lake Macquarie

We provide home visit physiotherapy in the following regions:

• Newcastle
  • Newcastle, Merewether, Hamilton, Adamstown, and nearby areas.
• Maitland
  • Rutherford, Maitland, Thornton, East Maitland, Aberglasslyn, and nearby areas.
• Central Coast
  • Budgewoi, Toukley, The Entrance, Wyong, Woy Woy, and nearby areas.
• Lake Macquarie
  • Charlestown, Belmont, Toronto, Warners Bay, and nearby areas.

Frequently Asked Questions

Who can benefit from mobile physiotherapy?

Mobile physiotherapy is perfect for individuals with mobility issues, post-surgery patients, NDIS participants, seniors, and busy professionals who prefer home-based care.

Do you bring all necessary equipment?

Yes, our physiotherapists can bring weights, exercise bands, creams, tapes, and any other required tools to ensure a full-service experience at home.

Book Your Mobile Physiotherapy Session

Get expert physiotherapy care without leaving your home. Whether you need rehab, injury treatment, or mobility support, our mobile physios are ready to help.

Don’t let pain or mobility issues hold you back. Call your nearest clinic today and get expert treatment at home!