Frequently Asked Questions About Travel and Vacations

Q: How do I come to terms with the fact that I can't travel like I had planned? When we were younger, my wife and I dreamed about spending our retirement years traveling the world. We are both avid hikers and cyclists, and we looked forward to exploring new places and cultures through walking and bicycle tours. As luck would have it, I developed rheumatoid arthritis, and now I can't walk or bike long distances due to knee pain. Obviously, our travel plans are out. I've tried to convince my wife to travel with her friends, but she refuses to go without me. I am so angry and bitter that I can't do what I want, and I feel guilty that I'm holding my wife back.

A: First of all, it is perfectly normal to be frustrated, angry or sad about your inability to travel the way you had planned. Essentially, what you are describing is a grieving process - you are mourning the loss of something that was very important to you. However, it seems that your thinking on this issue is very "black & white" - that is, if you can't do an active, hiking / biking holiday then it isn't worth traveling at all. If you persist in thinking this way then you will miss out on the many pleasures of travel that are still well within your capabilities. Vacations can vary widely with respect to the level of physical fitness required. For example, you could: 1) go on a cruise or to an all-inclusive resort, 2) take a "full service" bus trip which transports your luggage between locations, arranges all tours / activities etc, 3) take a more flexible bus trip that takes care of all transportation between locations but allows passengers the free time to explore as they wish, 4) travel between locations by rental car or train and use your motel room as a base for short walking excursions or exploration by scooter for a few days, or 5) rent an apartment in one location for a longer period of time & simply enjoy slowly exploring and living in that culture.

We have developed some Tips for Vacation Planning that we hope will be helpful, including the names of travel agencies which specialize in making travel arrangements for people with physical limitations. The Arthritis Foundation web page also provides good travel tips: www.arthritis.org/resources/travel.default.asp . Bon Voyage!

Q: How do I manage my pain on long flights? My extended family lives in Europe and I used to make the trip home every year. Now that I have arthritis, the trip is unmanageable. The flight is 10 hours long, and by the time we land I can barely walk due to the pain and stiffness. Last time, this symptom flare-up lasted for a week, which wrecked the whole trip. Is there anything I can do to keep my symptoms under control?

A: Air travel can be physically demanding, and can quickly result in increased pain and fatigue due to overexertion. Four things contribute to the strain of air travel: 1) carrying luggage, 2) walking long distances through airports, 3) prolonged sitting in waiting areas and on the flight, and 4) disrupted routines.
Carrying Luggage. When traveling, you often have to carry your luggage much further than expected. Carrying heavy suitcases, and even small carry-on bags, causes considerable strain on your back, shoulders and arms. The new style of wheeled luggage with long handles makes travel so much easier on your body. Invest in (or borrow) a large suitcase and a carry-on bag with the built-in wheeled cart. Also, I always tuck a bungee cord in the handle compartment. I have used it to attach my briefcase, purse, winter coat / boots, shopping bag etc. to my carry-on luggage during long layovers. You won't believe how much better it feels to pull your carry-on bag! Limit the amount of clothing and accessories that you are bringing as well try to bring compact items that will decrease the weight of your luggage. It may be worth getting a porter at the airport to lift your luggage from the baggage carrier and load it into a car for you.

Walking long distances. In some airports, you are required to walk miles from the check-in desk to your departure gate, from terminal to terminal, from your arrival gate to the customs / luggage area. It can be exhausting for someone in perfect health. Be sensible. If you can't walk long distances, ask for assistance. Better yet, request boarding assistance in advance when you book your tickets. Most airports will take you directly to your destination via a golf cart. Many of our patients are too proud to use this valuable service. My advice? Save your pride, your energy and your legs for the important stuff - sightseeing or visiting with family…If you do plan on walking make sure that you are wearing shoes that are supportive and comfortable. If you normally use a cane for walking long distances, make sure that you have it within easily access.

Prolonged sitting. Having to sit still for hours at a time is the worst trigger for increased pain and stiffness. The solution? Change position whenever possible. Walk around the waiting area until they begin boarding your flight. Choose an aisle seat so that you have room to wiggle your legs and change position while sitting. Some airlines will let you telephone ahead requesting seats with leg room, or let you choose your seat when you book your flight. Stand up and / or walk down the aisle as often as possible during the flight. Do some gentle stretches in your seat or while standing. If the thought of standing or stretching on the plane embarrasses you, ask for a seat at the rear of the aircraft where very few people will see you. Wearing loose non-restrictive clothing will also make sitting more comfortable.

Disrupted routines. Many people do their travelling all at once because they want to get there sooner and avoid wasting a moment of their vacation. As a result, they push their body well beyond its tolerance level while travelling, and then spend the first few days of their holiday trying to recover. If you want to prevent a pain flare-up, break up the travelling into manageable chunks, staying as close to your normal hours of work / exercise / sleep as possible. For example, if you have a 10 hour flight, followed by a 4 hour drive to your final destination, plan to stay overnight in the airport motel and make the drive the following morning.
You may find some other helpful travel tips on our Tips for Vacation Planning page. Bon Voyage!