How to determine duration of swimming and walking, OA – with or without meds?

mousy
mousy Member Posts: 6
edited 28. Nov 2023, 14:10 in Living with arthritis

Hello! I hope you will understand my question, English is not my first language which is why this post is so long, sorry about that. I'm 56 and I have OA diagnosed few months ago at lumbal and cervical spine. The problem with my back started 27 years ago with degenerative disc disease and sciatica. The problem spread very slowly throughout the body and now symptoms are chronic in the neck, lower spine, sometimes shoulders, knees and both hands. I also have mild nerve damage (c5-c8 and l4-s1). The cervical spine is the most sensitive, for example looking at the floor or to the side for only five-ten minutes causes pain. I work on the computer 40-50 hours a week. Because of the pain, I have to take more frequent and longer breaks.

 I have been taking meloxicam for last 12 years, but only occasionally, when the pain is severe (3-4 days every other week), also paracetamol but it helps when the pain is mild and only for a short time. For the past few years, the pain has started waking me up more often, today almost every night once or twice. When I take meloxicam, I sleep well. It would be great if I take meloxicam every day, but my physical therapist, MD doctor, neurologist and gastroenterologist don't think it's a good idea, so I avoid taking it, I bear the pain as much as I can.

I love swimming and walking, especially mountaineering with my husband. My condition and possibilities vary greatly depending on whether or not I take medication.

Without meds, I can walk 1 hour. More than 1 hour makes me pain and stiffness few next days. When I start climbing, my legs hurt, but half an hour later the pain disappears and I can climb for hours. One trip to the mountain of gently 2-3 hours walking makes me 3-4 days agony, pain in whole body.  But if I take meds, I can walk two days in a row on moderately difficult terrain 6-7 hours per day without problem next days!

 Same for swimming. I'm training it for a year's twice on week for an hour and it took a long time for me to realize that it has been causing me pain. Without meds, during swimming there is no pain, not at all, no matter how long I swam! If I swim longer, I feel fatigue in my muscles, like any other person, but there is no pain. The pain starts 4-5 hours after training, intensifies during night and the next day pain is very strong, especially near cervical spine, shoulders and fists that swell next morning. The pain subsides slowly after 3-4 days. I've tried different swimming techniques. It's the same, only another muscle is more affected. So, without meds, I can swim only 10-15 minutes without pain next day. But, if I take meds, I can swim one hour or more without pain next days.

I don't know now how to determine the duration of one swimming training session. I asked few therapist, rheumatologist and swimming coach, they answer that they don't know, but they all think that swimming and hiking is good for me. The rheumatologist also told me that I can take meloxicam every day, which is quite opposite other doctor's opinion. I'm also doing exercise every day for half hour (without meds), which my therapist gave me and I don't have pain after that, but one hour of exercise makes me pain.

So, this is my question for on-line community or Helpline Team - how to determine the duration of exercise/walking/swimming - according to the state without medication or with taking medication? Do I really need to stop swimming after 15 minutes? Or take the meds and swim more? How much more? Am I harming my joints if I take medication and swim for an hour? Should I stop hiking? I really like hiking and spending stress relief time in wild nature with my husband. Take the meds every day or just when the pain is strong? Thank you.

Comments

  • noddingtonpete
    noddingtonpete Moderator Posts: 983

    Hello @mousy and welcome to the community. We are a friendly and supportive group and I hope that will be your experience as well.

    First of all your English is excellent, if you hadn't said it wasn't your first language I would not have guessed. I think it is true to say that you should keep exercising and do as much as you can without it causing a lot of pain. If the medication helps keep the pain away then if the doctor says it is OK take it.

    You might find the following from our website of interest.

    and

    Please keep posting and let us know how you are getting on and I am sure that others will connect with you to share their support and experiences as well.

    With very best wishes

    Peter (moderator)

    Need more help? - call our Helpline on0800 5200 520Monday to Friday 9am to 6pm

  • Lilymary
    Lilymary Member Posts: 1,740
    edited 6. Feb 2023, 18:00

    Hi Mousy, I'd say listen to your body, which you seem to be doing already, but the fact you've asked this question suggests you're worried about whether you're overdoing it.

    There are no hard and fast rules about how much exercise to do, it will be different for everyone. It's important to keep exercising , but overdoing it can result in flare ups, which you've found (as I did) can take 4 days to settle. So I'd suggest you experiment with moderating the amount of exercise you do until you can find a level which doesn't result in long flare ups and recovery periods. Little and often may be the way to go - some of your mountain walks sound pretty punishing on a body that's below par (I'm also a fell walker, although the big peaks are sadly probably beyond me now).

    If the meds enable you to exercise for longer and don't give you unpleasant side effects. keep on with that routine. A big part of arthritis is simply pain management to keep your body mobile and keep doing the things you love, but you do need to listen to your body, and it sounds to me like you're pushing it at any cost at the moment and I think you realise this. I had terrible OA in my hip (now replaced) and have an active job. So if I knew I had a busy day I loaded up on pain relief and scheduled in a few rest days afterwards, and moderated the meds on easier days. It was still hard going though, and there's no shame in allowing your body to recover or simply slow down a bit. We can't keep yup the high octane indefinitely, sadly, but I've learnt to enjoy valley walks or coastal walks just as much as the high tops. I let my husband off the leash to do the big stuff with one of his friends, and I'm not struggling to keep up and in agony during and after (which really takes the pleasure out of it), so we're both happy.

  • mousy
    mousy Member Posts: 6

    Thank you Peter for nice welcome and useful links where I found some answers to other people questions about swimming, meds, walking and hiking. It helps me a lot :)

    And thank you Lilimary for sharing your experience with me. It's always good to hear how people deal with similar problems. Your post and your advice is very important to me <3

    I like how you summed up the problem, yes, I really need to learn pain management. I also enjoy valley walks and coastal walks just as much as the mountain. But the big tops my husband from the beginning always climbed with his friends, especially during winter, when I stay at home. He is an alpinist, speleologist and mountain rescuer, I'm just a regular mountaineer. I walk slowly as a snail, this is the reason why some trips last 6-7 hours. Fortunately, my husband is patient, because he would have covered the same distance in half the time.

    Spending time in nature is very important to me, so thank you both again for helping me to find a way to keep it!

  • mousy
    mousy Member Posts: 6

    I've just realized that I used wrong word in my posts. (Well, Peter, I have problem with English, after all). According to this definition (https://monkeysandmountains.com/hiking-trekking-mountaineering/) I don't climbing and mountaineering at the mountain, just hiking. I did some mountaineering, but it was a long time ago, when I was young. It is too hard for me now. Thank you for your patience.

  • TLee
    TLee Member Posts: 88

    I came here today with the very same question, and found help even without having to ask it myself. How wonderful! I have bone-on-bone OA in my left hip. I used to hike or, to be more accurate, take long walks. Now most days I can just about manage down my road and back (probably 1/4 mile, slight incline on the way back). We've had a couple of nice days after a cold snap, and yesterday I decided I just had to get out to a park for a longer trek. The path I chose was pretty flat, but uneven in spots, and I'm guessing I managed about a mile and a half before real pain set in. I was nearly in tears before I reached the car, and spent the rest of the day lying down & screaming with every movement. After a night's rest, I am feeling pretty much back to normal so I guess no harm done(?). I have to wonder though, is the pain just after the increased activity worth the benefit, both mental and physical, of staying active? I felt some odd movement and kind of a clicking sensation after walking for some distance, which made me wonder what kind of damage I might be causing. I know that in physical therapy they stressed NOT moving until I was in pain, which makes me wonder even more. I think that the suggestion to exercise in moderation makes a lot of sense, I guess I just need to learn exactly what that means for me.

  • mousy
    mousy Member Posts: 6

    Hi TLee, did you take some meds before longer trek few days ago? When I take the meds before walking, then I can walk longer and with much less pain afterwards.

  • TLee
    TLee Member Posts: 88

    I can really only take acetaminophen, which I don't find a great help. My doctor has suggested taking it regularly 2 or 3 times a day to act more as pain prevention rather than trying for pain relief. I have to admit that I have yet to take that advice. It has been a couple of days since my longer trek, and I am still in more pain that is normal, and in different places. I now feel it down my femur, and it almost feels like something is slightly out of place, as I can push in on my upper leg as I walk & feel some small improvement. I also get some sharp, stabbing pain even when I am being still. All this makes me fall into the camp of those who say yes, it is possible to exercise too much! Next time I'll choose a more reasonable route to walk, and no more letting the dog talk me into "once more around the park"!

  • mousy
    mousy Member Posts: 6

    From my experience acetaminophen helps, but only for a short period. It must be a reason why you doctor has suggested taking it regularly 2 or 3 times a day. But with such severe pain as you describe, and I felt it sometimes, it was also not enough for me. At the begginig of this conversation, Peter (moderator) put this link https://www.versusarthritis.org/about-arthritis/treatments/drugs/painkillers-and-nsaids/ I founded there that acetaminophen isn't enough and for severe pain we need to take it together with ibuprofen or some other NSAID. I would suggest you look into it, because it helps me. I can walk more and without severe pain after if I take NSAID + acetaminophen. My severe pain starts when I don't take meds.

  • TLee
    TLee Member Posts: 88

    I have heard before of alternating acetaminophen and NSAID. My husband suffered several broken ribs a while back and that was the recommended procedure for his pain. Unfortunately, I take other meds that can interact with NSAIDs, so I am very limited in my pain treatments. I have to say, arthritis is the most confusing, aggravating and painful health issue I have ever experienced!