Hiking with Arthritis: What to Know Before You Go

Get your move on this autumn with these doctors' tips for keeping arthritic pain in check.

Fall, with its brilliantly colored leaves underfoot, sunny skies above, and crisp, invigorating air, is the perfect season for hiking. If you’ve been taking advantage of this fun outdoor activity for years and now find that arthritis is holding you back, here’s some good news.

Whether you have rheumatoid arthritis or osteoarthritis, you can still enjoy a hike and reap the health benefits at the same time, experts say.

“Hiking is great for arthritis because it keeps the joints mobile and the surrounding muscles strong,” says Adam Rivadeneyra, MD, a sports medicine specialist at Hoag Orthopedic Institute in Orange, California.

Besides benefitting your joints, hiking promotes good cardiovascular health, adds Sonali Khandelwal, MD, a rheumatologist at Rush University Medical Center in Chicago.  “Hiking is a great opportunity to get some cardiovascular exercise and getting outside and enjoying nature also benefits your overall health,” she says.

When hiking with arthritis, choose level ground and a familiar route to avoid troublesome hills and rocks. (Image: Curtis MacNewton, Unsplash)

Before You Go

Plan your hike for early in the day, recommends Jennifer Kawi, PhD, FNP-BC, an associate professor of nursing at the University of Nevada in Las Vegas who specializes in chronic pain management. “There won’t be as much of a crowd so you will have more room to get around and you can pace yourself and not feel rushed,” she advises.

And plan to hike on level ground, suggest Dr. Khandelwal suggests, so that you can avoid any routes that involve hills and valleys. “If your arthritis is well-controlled and you’ve been active for years, that’s another story,” she says, however. In that case, you may be able to try a more challenging course, depending upon the advice of your physician.

It’s crucial that you hike on trails you are familiar with, says Dr. Rivadeneyra. “Your route should feature well-marked trails, with few large rocks or unstable terrain,” he says. “Turning a short hike into an all-day struggle to find your destination can be disastrous for anyone but especially those with arthritis,” he says.

Above all, don’t be overly ambitious. If you haven’t been out for a while, don’t attempt a two-mile hike, says Lynn M. Ludmer, MD, medical director of rheumatology at Mercy Medical Center in Baltimore, MD.  “The biggest complaints I get are from patients who are generally inactive and then do a lot of exercise without working up to it,” she says. “Start gradually. Concentrate on flat ground first to see how it feels and take frequent rest periods.”

Also, she advises, don’t wait until you are exhausted or in pain to head back. By knowing your limits, you can plan to turn around after a set amount of time.

On the day of your hike, stretch before you head out, recommends Dr. Khandelwal.

Practical Takeaways:

  • Hike early to avoid crowds
  • Choose a path you’re familiar with, ideally on level ground with minimal hills and rocks
  • Stretch before you head out
  • Keep any pain—and your route back—in check in order to avoid overdoing it


Should I Medicate Preventively?

Most arthritis medication should be continued as usual when hiking. Do check with your doctor about your specific medications.

Talk to your doctor to see if it would be permissible for you to take some over-the-counter or prescription medication for pain about half an hour before you start to hike, suggests Dr. Ludmer. “Unfortunately, some patients have other medical conditions which prohibit the use of these types of medications,” she says. “I this case, topical over-the-counter medications can be helpful as well.” (eg, Salonpas patches, capsaicin cream, Icy Hot gel)

Of course, if you have allergies, you may want to carry emergency medications like asthma inhalers or epinephrine if your doctor recommends these, says Dr. Rivadeneyra.


What to Take

You’ll need shoes with good soles and excellent arch support so they will support you as you make your way along a trail.  You may opt for hiking sandals, running shoes, or hiking boots, says Dr. Rivadeneyra. “Experiment with any new shoes on very short outings in familiar locations,” he advises.

Plan to take a backpack with you for your supplies as well, says Dr. Kawi. “Choose one that is light and that is belted to the hip and waist,” she says. “This helps with stability.”

Take plenty of water, sunscreen, snacks, and, for safety’s sake, your cell phone, says Dr. Rivadeneyra.  You may want to carry the backpack around a bit before you go hiking to make sure you are able to wear it on the trail, he says.

A walking stick can help stabilize you, says Dr. Khandelwal. Unlike a cane, which is meant to help you walk, a walking stick offers stability and something to hold onto even when you are not on level ground. The stick also can reduce the stress on your back, knees and feet, says Dr. Rivadeneyra.

If you have arthritis in your knees or ankles, consider wearing ankle and knee braces and knee sleeves, which are compression sleeves and can be very helpful, says Dr. Kawi.

Finally, consider packing a book as well, suggests Dr. Ludmer. “This way, your hiking partners can keep going if you need to stop to read and recharge,” she says.

Consider icing or taking over-the-counter preventive medication before you hike with arthritis (Image: Mott Rodeheaver, Unsplash)

Know Your Limits

If you feel good on a certain day, take advantage and go a little further if you can, says Dr. Rivadeneyra. “On bad days, though, you may want to choose another activity rather than going hiking,” he says.

Pay attention to the cues your body is giving you to know when to stop, says Dr. Khandelwal. “If you have rheumatoid arthritis and you start to feel like you are swelling, stop hiking and ice the area,” she says. “If you have arthritis in your knee, you also could wear a knee wrap while hiking to help stabilize the joint.”

Icing before and after hiking is a good idea in general, but don’t worry about elevating your legs unless you have issues with edema and your calves appear swollen.

If you do decide that you are fit enough to try hiking on a slope, you may get nervous on the way back as you are descending. When hiking on a downward slope or going down multiple steps, move forward and go down in a zigzagging motion, where you go to the right, then to the left, and then to the right again, recommends Dr. Kawi, because this lessens the pressure on your knee joints. Some people also tend to walk too flexed forward when carrying a backpack and hiking. Try to avoid doing this since it can decrease your stability, she suggests.

Notes Dr. Khandenwal, “Everyone’s tolerance activity level is different. If you are new to hiking, perhaps resting a little longer, like a few weeks, in between hikes makes sense, but if you are used to hiking than you can likely do daily hikes.” 

Overall, follow your body’s responses and aim not to overdo it. Slow and steady always wins.



Updated on: 10/03/19
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