A Weekend Hike and the Painful Aftermath
I thoroughly enjoy hiking--it’s one of my favorite weekend and after-work activities. Hiking means my joints get some much-needed movement, my body some low-impact exercise, and my mind a bit of nature therapy.
With the pandemic this year and the need to be extra cautious within indoor spaces, I’ve turned to the outdoors more. My wife and I hiked nearly every weekend of the 2020 summer, and during that time I was able to build up some stamina so that I could push further and harder. Of course, everything depends on how my ankylosing spondylitis is behaving on any given day.
But we had a lot on our plate this fall and weren’t able to hit the trails as often, which means I lost a lot of that hard-earned stamina. Getting back on the trails now is considerably harder on my joints than it was mid-summer.
Hiking with ankylosing spondylitis
When I hike, I have to be cautious and make wise decisions. Before the hike, I do my research. I choose trails that aren’t too intense and that lack steep inclines, which would surely be hard on my hips and lower back. Out on the trail, I'm conscious of my mileage and how my body feels. I check in frequently, and if I’m experiencing pain that’s getting exponentially worse, I know it’s time to cut the hike short.
I also pay attention to the weather conditions, the gear I need or might need, and the conditions on the trail. When the weather is cold, my joints ache more. Whether my joints are me bothering before the hike or not, I like to bring along my knee brace, pain cream, and an ace wrap just in case. If I’m hiking at elevation (and therefore breathing harder), I pay extra attention to my pace and how quickly pain levels in my chest are increasing with costochondritis.
My December 4-mile hike
After a two-month stretch with little hiking, my wife and I decided to hit the trails at a local state park and tackle a relatively flat 4-mile loop in 20-degree weather. We both bundled up and headed out.
As per usual, the first 2 miles were easy going and I only battled my usual moderate lower back pain. But as the trail wound its way up and over some hills, I could feel my back tightening up. Every time I stepped down off a rock or picked up speed on a descent, the throbbing in my lower back intensified.
The further we trekked, the more my back pain increased. At mile 2.5, I found myself walking rigidly, not wanting to make any sudden movements that might increase the pain. Since this was a 4-mile loop trail, turning back was not an option anymore. At mile 3, my hip joints started acting up too. We decided to slow down and take frequent short breaks as we finished the loop. Finally, after an iffy last mile on the trail, we arrived back to where we started.
The after-hike recovery
When I’m in shape, a 4-mile hike will leave me with mild-to-moderate pain and fatigue for the rest of the day, but nothing that would stop me from getting up and doing it again the next day. This hike, on the other hand, made me forfeit the remainder of my weekend (the rest of Saturday and all of Sunday) to recovery.
After attempting a few tasks around the house on Saturday, I threw in the towel, grabbed my heating pad and pain medication, and headed to bed. My hip joints felt like they were being squeezed in a vice, and no matter which way I turned or how I repositioned, I could not ease the pain.
Needless to say, falling asleep Saturday night wasn’t happening without something to ease the pain. I closed my eyes that night and tried lulling the pain away to the refrain of “please stop, please stop, please stop.” Somehow I managed a bit of sleep that night, interrupted at regular intervals by throbbing pain from laying in one position for too long.
For me, this experience was a useful reminder that, no matter how good I feel on any given day, it could all go downhill quickly with this disease. Activity is good for AS, but too much activity quickly turns into a nightmarish scenario. I need to remember not to attempt more than my body can handle, at least not without an escape route handy!
Other than back pain and fatigue, what is the most common symptom that AS patients experience?