In the spring, a young man’s fancy may turn to thoughts of love, but in the summer, most of us begin dreaming of a vacation, be it a cross-country road trip to visit family, a long-planned tour of Europe or a luxurious cruise to exotic ports of call.

Whatever the destination, travel today involves more hassles than it did 20 years ago, including longer lines at airport security, cramped airline seats with less legroom and more crowded highways. All these are inconvenient enough, but if you have rheumatoid arthritis, travel poses special challenges.

Maneuvering heavy, unwieldy luggage, walking long distances along crowded airport concourses and standing in endless lines can strain the joints in the hands and feet, causing pain and swelling and increasing fatigue. Eating in restaurants can make it more difficult to control what you eat, and a high-sugar, high-fat diet can increase inflammation throughout the body. Time zone changes can play havoc with sleep and medication schedules.

“Travel is stressful, whether you go for business or pleasure,” says Dr. David S. Pisetsky, a professor of medicine and immunology at the Duke University School of Medicine in Durham, North Carolina. “And doing more activity than usual can make people [with RA] feel worse the next day.”

Theoretically, it can even increase the chance of suffering a disease flare, he says.

[See: 7 Surprising Things That Age You.]

So should people with RA avoid travel?

The short answer is no, says Dr. Eric Matteson, a rheumatologist and former chair of the Department of Rheumatology at the Mayo Clinic in Rochester, Minnesota. “I encourage patients to travel for fun and do what they feel up to,” Matteson advises.

However, a little planning is necessary to help ward off problems and maximize the travel experience. “Always make sure you take enough medication with you, and that it’s stored correctly, including taking a cooler for meds that require refrigeration,” Pisetsky says. This advice is especially important for people in pain who require opioids. “It’s important to have enough because if you run out of them, you may not be able to get more,” he cautions.

“Keep taking your medications on schedule,” Matteson advises, which may mean adapting the schedule to changing time zones, if necessary.

When flying, “get out of your seat and move around,” Pisetsky says. “It can help prevent blood clots and reduce stiffness.”

Matteson agrees. “Get up and stretch! It’s really important.” This advice also pertains to driving. “It’s best not to sit for more than an hour while driving,” he says. “And even on the plane, get up at least once an hour during waking time.”

Keep medications and supplies in their original packaging and take them in your carry-on luggage. Never pack them in checked luggage. Also, take a letter from your rheumatologist detailing your medical condition and listing your prescribed medications, including generic names. This can help you obtain medication in a foreign country if you happen to lose your supply.

To maximize comfort and reduce the chance of fatigue, let the airline know in advance if you need a wheelchair to help you maneuver through security to check-in and boarding at your gate. “At some airports you have to travel very long distances,” Pisetsky says.

And select your footwear with care. “Wear your old, comfy shoes,” Matteson advises, “not new ones.”

Pack as light as you can to lighten the luggage load as much as possible. Matteson also advises getting a rolling suitcase that has four wheels.

[See: How to Practice Yoga When You Have Arthritis or Another Chronic Condition.]

Kimberly Steinbarger, a physical therapist and director of clinical education in the School of Physical Therapy at Husson University in Bangor, Maine, agrees. But she takes this advice one step further. “The wheels need to spin on the bottom of the luggage so it is easier to maneuver into elevators, and such,” says Steinbarger, who has RA herself.

“I also love my backpack for a carry-on. I don’t carry things in my hands; it’s too painful,” she adds. “[My backpack] is one of those TSA-friendly bags that zips open to lie flat. It keeps my laptop on one side and [everything else] on the other. That way, I don’t have to remove anything other than my shoes and jacket to get through security. Slip-on shoes help with that.”

RA is an autoimmune disease in which the immune system mistakenly attacks the body’s own healthy tissue. Many current RA medications work by suppressing the immune response, including corticosteroids like prednisone and biologics such as Humira, Enbrel and Orencia. People with RA who take these medications are immunocompromised — they have weakened immune systems — and need to take special precautions when traveling to prevent infection. “The risk of contracting an infection is increased in some countries, so it’s important to get all of the necessary immunizations, including hepatitis vaccines, if possible,” Pisetsky says.

The website Cancer Network offers several tips for immunocompromised travelers planning foreign travel. They include avoiding tap water and ice, raw fruits and vegetables that cannot be peeled and unpasteurized dairy products; using insect repellent to avoid insect bites; taking prophylactic anti-malaria medication if you’re going to a country where malaria is endemic; and bringing over-the-counter or prescription medication to treat traveler’s diarrhea.

Pisetsky suggests consulting a travelers’ clinic before you embark, for immunization recommendations and other advice for avoiding infections. “They’re experts in this area,” he says. The Centers for Disease Control and Prevention can help you find a clinic in your area.

[See: 12 ‘Unhealthy’ Foods With Health Benefits.]

Wherever you go and however you get there, whether you’re traveling for pleasure or business, build in time for rest. Steinbarger, who must travel several times a year to attend professional seminars, has learned this lesson through experience. “I make sure I schedule time to return to my room and rest. I have to, to balance seminar attendance with the social and networking activities [which are] more draining for me,” she says. I would love to be more spontaneous, but it usually doesn’t end well.”

Ultimately, if you have RA, a successful trip “all comes down to knowing your own body and planning for it,” Steinbarger adds.

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Travel Requires Special Precautions if You Have Rheumatoid Arthritis originally appeared on usnews.com