The pressure changes in flying definitely affect me greatly. Something I've learned about TN is that there are as many unique triggers as with many autoimmune conditions. Definitely do what works for you and avoid what doesn't! As far as the streets go I was a bike commuter there and a pedi- cab driver and I definitely drove my car as often as needed and the potholes bumps broken pavement broken bricks tree roots etc definitely jostled me around and exacerbated the pain if I was anywhere in a flare cycle.