Features June 2004 Issue

Traveling And Arthritis

How to make summer vacationing less taxing, more relaxing.

Vacations are supposed to provide some much-needed R&R, but more often than not, the thought of traveling conjures up one big headache. Juggling armfuls of heavy luggage, sitting for hours in cramped seats, even tossing and turning in unfamiliar beds can send the sanest traveler into a tailspin.

And when you suffer from arthritis, travel is not only frustrating—it can be downright painful.

“Patients with inflammatory types of arthritis have problems with stiffness, so if you’re immobile for lengthy periods of time—such as a long airplane ride—the stiffness is far more profound, and it may be a lot harder to get going again,” says Cleveland Clinic rheumatologist Dr. Robert McNutt.

Experts say walking or stretching every 30 minutes or so is a good way to get the joint fluids moving and help reduce stiffness. Another way is to avoid excess stress on the joints—wisdom that’s largely ignored while traveling.

“Typically, travelers carry more and are involved in more activity than they normally would be, and that overstresses the joints,” says Brenda Greene, an assistant professor in the Department of Rehabilitation Medicine at Emory University in Atlanta.

The key, she says, is planning ahead, which can make all the difference between a taxing—and relaxing—vacation. Here are some tips to help manage your arthritis while on the go.

Rules for the road
• Understand and accept your physical abilities and limitations. Know what amount of lifting, activity, and sitting is going to aggravate you.

• Don’t be reluctant to ask for assistance. If you have arthritis in your hands, for example, ask a flight attendant to help you fasten your seatbelt.

• Always stick to your normal medication routine. Bring extra medications (in your carry-on luggage), a spare prescription, your medical insurance card, and your doctor’s phone number in case of emergency.

• Maintain your regular exercise regimen and a healthy diet as much as possible.

• Wear comfortable, well-cushioned shoes.

• Wear support hose—to prevent edema—if you plan to sit for long periods of time.

• Get support. Use a small lumbar support for your lower back, such as a small rolled-up towel. This is especially helpful if you suffer from lower back pain or arthritis of the spine.

• Travel during your peak energy period. What time of day do you feel best?

• If you have a complicated disease, ask your physician to write a disease summary (it doesn’t have to be detailed) that you can give to a new doctor in case of an emergency.

Lugging luggage
• Before you leave, plan on what bags you’re going to carry and how you're going to carry them. “Even if you plan to check your luggage,” says Greene, “you’ll still need to get the bags from your house to the airport.”

• Use the services of a porter and curbside check-in; carry small bills for tips.

• Check your bag if it weighs more than 15 pounds. If you’re only comfortable lifting a 5-pound object over your head, then check everything.

• When lifting luggage, bend at the knees, keep the back straight, and use both hands to pick up your bag. When you lift the bag, straighten your knees as you stand up so the stress is on your thigh muscles and not your hands or back.

Flying
• Allow plenty of time to get to your gate. If you have trouble walking, call the airport ahead of time and arrange for a wheelchair or courtesy shuttle.

• If possible, book a non-stop flight to avoid long walking distances to transfer planes.

• Consider your seat assignment. An aisle seat offers more opportunity to stretch your legs and walk around. If you can’t easily get up, opt for a window seat so you won’t have to make way for other passengers who may need to leave their seats.

• Stretch. Stretching encourages fluid circulation and makes joints and muscles less stiff. While seated, straighten your legs as much as possible. Point your toes up torward your head.

• Flex your muscles. The Arthritis Association suggests wall push-ups to keep your calf muscles flexible: Stand two feet from a wall. Place your palms on the wall and point your toes inward. Keeping your knees straight and feet flat, lean forward onto your hands without bending at the waist. Hold for 10 seconds, and then gently push away from the wall.

• Prepare for landing. If you have arthritis of the spine, face forward as you get close to landing and push down with your hands on the armrests. This decompresses the spine. When the plane lands, the jolt will go into your hands and arms and not your back.

Road trips
• The seat-angle position in a car is important. The goal is to maintain a slight curve in the lower back without forcing it. If your car has an adjustable lumbar support, use it. Or roll a small towel and place it behind you.

• The car seat should be far enough back so you can almost fully extend your legs.

• For long road trips, schedule stops every hour to stretch and avoid joint stiffness.

• If renting a car, confirm that it comes with power brakes, windows, mirrors, and locks.

• Exercise at stoplights. Roll your shoulders, tilt your head from side to side, and stretch your neck.

• Maintain good posture by adjusting your rear-view mirror so you have to sit up straight to use it.

Once you’ve arrived
You've reached your destination; now it’s time to relax. If traveling has made your joints stiff, hot, or inflamed, throw some ice in a plastic bag (be sure to pack a few) and rest it on your sore spot. The cold temperature will constrict your blood vessels and prevent fluids from leaking into surrounding tissue, thus reducing pain and swelling.

If a good night’s sleep is out of the question because of a soft mattress, rolling a towel under your neck (or waist if you sleep on the side) can sometimes help. Or ask for a room with a newer mattress or firmer bed.

Finally, never forego a vacation because of fear. “If you think you can’t travel,” says McNutt, “that’s when you need to. Many patients say ‘I’ll go when I feel better,’ but sometimes a vacation is a place where you'll end up feeling better.”

Bottom line: Think ahead, take a few precautions, and you’ll never have to take a vacation from your travels.