Editor’s note: This article isn’t a substitute for professional medical advice, diagnosis or treatment. Each person’s experience with chronic pain is different, so consult a health-care provider when choosing your activity or treatment plan.
I first fell in love with movement as a child in rural Ohio. It started with exploring nearby trails, racing to the neighbor’s gas well with my raucous brothers, building ramps to jump bikes and climbing every tree I could. I never questioned my abilities to run or hike long distances.
But while mountain biking in 2012, at 42 years old, I tore the medial meniscus in my left knee. A few years later, I learned I had early onset osteoarthritis. (Injury can increase the chances of developing the condition.) Periodic cortisone shots and ibuprofen helped manage the pain and stiffness, and, aside from giving up running, my aptitude for adventuring persisted.
Then, in 2023, I planned a hiking and biking trip to several islands in the Indian Ocean. I intended to spend five days trekking the Cirque de Cilaos on Réunion Island, including a day climbing the 10,000-foot dormant shield volcano Piton des Neiges and 8,631-foot active volcano Piton de la Fournaise. Most people complete the first in about eight-and-a-half hours and the second in about four. I knew my joints weren’t what they once were, but I trusted them to carry me through as they had on so many previous trips.
My knees ached as I maneuvered the rocky, volcanic terrain. This, I had expected. Sharing the trail with throngs of hikers, though, made it challenging to pick my line and pace. After the first mile, my knees swelled, and I began navigating the steep, uneven descents sideways to alleviate direct pressure on my joints. With stops and a couple missteps, the hike took me well over 12 hours to complete, and it exacerbated my pain. I felt proud of what I’d accomplished, but also a little betrayed by my body.
One of the most difficult parts of living with chronic pain is reconciling what I can and can’t do, especially as it relates to my time outside. And I’m not alone.
I recently spoke with three chronic pain sufferers who have also had to reframe their relationships with the outdoors. Read on to hear from a cyclist navigating an autoimmune disorder, an ultrarunner who discovered a new passion after injury and a woman moving through a fibromyalgia diagnosis. Here’s how they cope—and their tips for how others can, too.
The Many Forms of Chronic Pain
There are myriad causes for chronic pain, which experts define as lasting longer than three months. Triggers can include autoimmune disorders, injury, disease or a traumatic accident and, according to a 2023 study from the Centers for Disease Control and Prevention, about 24.3% of people in the U.S. battle chronic pain, with women reporting higher rates than men.
For Meghan Young, a Seattle-based mountain biker, hiker and REI Member, the pain began after breaking her foot while mountain biking in 2013, and again the following year while hiking. She also suffered a high ankle sprain on the same leg a couple years later. For years, Young believed her injuries caused her chronic pain pain, but doctors eventually diagnosed her with two unrelated ailments: the chronic nervous system disorder fibromyalgia and mast cell activation syndrome (MCAS), a condition defined by overreactive immune cells that contribute to symptoms like swelling and fatigue.
Because many pain medications can exacerbate MCAS, Young manages her discomfort by stretching, icing her joints and muscles, and managing her expectations outdoors. She chooses shorter hiking trails with less elevation gain and moves at a more leisurely pace.
“As mad as I sometimes am with my body, I’m still so grateful for the things that I get to do,” she says.
Ultrarunner Jenny Thorsen embraces a similar approach outdoors. Thorsen’s pain stems from broken bones in her spine, which caused discs to shift and pinch a nerve, leaving her with debilitating pain. As a result, she can no longer tackle the 50-milers she once enjoyed. Instead, she’s found peace through an activity she likes almost as much: photography. Now she visually documents ultra races rather than run them. This switch in perspective allows her to enjoy the outdoors without exacerbating her pain. When Thorsen does opt for short runs, she manages her discomfort with supplements, knee braces and what she calls “reasonable expectations.”
“I can run shorter distances, slow down and enjoy the scenery more,” she says.
“I tell other people’s stories [through my photography], which has actually been a lot more fulfilling because now it’s not just all about me. I feel as if I have a legacy,” she adds.
How Movement Can Help
Experiencing chronic pain doesn’t have to sideline you outdoors. Like Thorsen and Young experienced, it’s possible to reimagine what it means to enjoy time in nature. And research shows that movement can actually be beneficial for managing symptoms.
Patrick Siegle, a physical medicine and rehabilitation specialist at Gaylord Specialty Care in Connecticut who regularly treats patients with chronic pain, explains that there are several reasons movement can help:
Movement provides proprioceptive feedback, or sensory input that helps the body sense its position, motion and balance through signals from muscles, joints and nerves. This input activates non-pain fibers, which help reduce the intensity of pain signals to the brain. Exercise also releases endorphins, which can help block pain signals.
Additionally, increased blood flow from exercise can decrease inflammation by recycling cellular debris. Because inflammation can cause swelling and put pressure on nerves, decreasing it can reduce discomfort.
Activities that get a person outdoors—like hiking, biking or walking—have an added benefit for pain management: Being outside can help regulate a person’s circadian rhythm, or the internal clock that regulates sleep-wake patterns, and research shows that a person who gets higher quality sleep has higher pain thresholds.
There are also psychological benefits to movement. A 2019 study showed that spending just 120 minutes outside a week can improve well-being. As Young says, “Any day we get to go outside and play is a good day.”
Tips for Hiking or Backpacking with Chronic Pain
Getting outside can feel daunting when you’re experiencing discomfort. Here, experts and individuals who experience chronic pain offer tips for managing it outdoors.
Listen to your body
Mercedes Fernandez, a geriatric physiotherapist, kinesiologist and founder of Mouvement Geriatric Physiotherapy in California, says some people try to push themselves faster or farther when they feel pain or exhaustion. This can cause injury. Instead, people should listen to their bodies, which may mean turning around early on a hike or taking a rest day.
“The most beautiful thing I’ve learned in my career is that the human body is so intelligent. And we often don’t listen to it,” she says.
Slow down
Whether you’ve taken time away from an activity to address your pain or are beginning a new-to-you pursuit, it’s best to start slowly to avoid injury or exacerbating discomfort.
Fernandez and Leia Rispoli, an interventional pain management specialist and physical therapist at DISC Sports and Spine Center in California, says to stop an activity and consider seeing a medical professional if you notice any of these symptoms:
- Unrelenting pain that doesn’t let up when you take a break
- Numbness, tingling or weakness
- Swelling
- A muscle that feels hot to the touch
- Bruising
- Sharp pain
Schedule breaks
No matter the activity, make time for regular rest stops. This gives your body time to acclimate and allows you to check in with yourself. If you’re worried about judgement from passersby, Danae Horst, an REI Member who lives with chronic pain, suggests taking a photo or drinking some water.
Make small tweaks
Rethinking how you spend time outside doesn’t have to mean giving up activities you love. Small adjustments can make a big difference. For instance, if you enjoy backpacking but find long treks and sleeping on the ground too uncomfortable, consider car camping. You can still enjoy shorter hikes near camp and have the option to move your sleep setup to a vehicle. Horst did this on a recent trip to Death Valley.
“I’m not backpacking anymore, and I’ll never be a thru-hiker,” she says, “But there are ways to keep engaging with these things that really give me life.”
Invest in the right gear
Lydia Nemirovsky, an occupational therapist and CEO and founder of Specialty Pain Management Services in Maryland, stresses the importance of considering comfort and function when choosing gear. For example, make sure your hiking boots or trail-running shoes provide proper support. Depending on your foot anatomy, you may benefit from insoles to support your arches or a taller boot to support your ankles. If you’re unsure what you need, you can visit your local REI store for a fitting or consult a specialist, like a physical therapist. (Related reading: How to Choose Hiking Boots)
If you’re hiking or backpacking, consider the weight, size and position of your backpack. You can try on packs at your local REI store to find the proper fit and consult a specialist for tips on what might work best for you. If your upper back bothers you, for instance, you could consider a pack with a sturdy hipbelt to offload some weight from your shoulders to your hips.
Other camping and hiking gear to consider:
- Thick sleeping pad or mattress to avoid hip and back strain
- Camp pillow to support your head and neck
- Supportive camp chairs for resting at the end of a long day
- A massage tool for relieving sore muscles
Drink water
Hydration is incredibly important for pain management, Siegle says. Proper hydration helps prevent muscle cramps and mitigates muscle and joint soreness. It also lubricates and cushions joints, flushes toxins and keeps muscles soft and functioning. (Related reading: Hydration Basics)
Pack strategically
A lighter pack can feel easier to carry on treks. Here are a few tips for minimizing packed weight:
- Portion food and personal care items into smaller, lighter containers.
- Choose lightweight, collapsible water bottles.
- Invest in lightweight gear that doesn’t require sacrificing comfort, like a lightweight backpacking tent you can pitch with your trekking poles or a lightweight sleeping bag.
- Consider a trail-running shoe over a hiking boot. These can help trim weight. (Related reading: Trail-Running Shoes Buying Guide)
- After every trip, list unused items you can leave behind on your next adventure. Note: This tip only applies to nonessential items—not safety or preparedness gear. (Related reading: The Ten Essentials and How to Pack and Hoist a Backpack)
Prioritize aftercare
To avoid stiff and sore muscles, partake in an active rest day following a backpacking trip. An active rest day includes light physical activity that differs from your normal workout regimen. Pilates, yoga and active stretching are some examples. Consider booking a massage or an acupuncture session following your trip. Some health insurance plans cover these kinds of treatments. (Related reading: Yoga for Hikers, Foam Roller Exercises and How to Recover from a Hike)
TKTK [Think this could benefit from a last encouraging line!]