Driving with Arthritis

“My car is my life; I don’t know what I’d do without it,” says Gemma H., who has rheumatoid arthritis. Not only does her car get her to important places like her job as a daycare provider, local stores, and doctor appointments, but her car has also become her “safe space.”

“It’s almost like my shield from the world. When I’m in a lot of pain I just go hide out there,” she explains. “I have my snacks, some pain meds, my phone charger, a magazine — everything I need to relax.” And, she adds, she can easily make the temperature in the car extra hot, which feels soothing on her joints, especially after a long day of lifting children.

Being able to drive a car is really important, especially for people living with arthritis, as they depend on their cars to maintain their mobility, independence, and social participation, according to a study from Canadian researchers published in the Journal of Occupational Therapy. However, driving with arthritis may be easier said than done, thanks to the pain, exhaustion, and reduced function associated with the disease.

“Driving is a complex task that requires the interaction of visual, cognitive, and motor skills to perform even basic maneuvers, such as braking and steering,” the researchers noted. “A change in any of these skills can affect driving safety.”

It’s hardly surprising, then, that about half of people with rheumatoid arthritis (RA) reported some difficulty driving, according to a survey of more than 700 RA patients published in the Journal of Rheumatology.

In another study, researchers surveyed people with RA about the types of issues they dealt with while driving. Two-thirds of patients reported specific problems with driving. About half had trouble getting in and out of the car, about one-third had issues backing up, and about 25 percent had issues looking left and right at an intersection.

But perhaps the truly astonishing finding was that the majority of people in the study had a disability index of less than one, which means that even people with low functional impairment still experienced a significant level of driving difficulty. It turns out that even a little bit of arthritis can cause noticeable issues.

There are several ways that arthritis can make driving more difficult, according to the National Institutes of Health (NIH):

1. Joint pain and stiffness can make it harder to do basic driving functions like turning your head to look back or check your blind spot, turning the steering wheel quickly, or braking safely.

2. Some medications used to treat arthritis can cause sleepiness, dizziness, or other side effects that can impair your driving ability.

3. Mental fog and fatigue from the disease can slow your reaction time and reflexes.

What can people with arthritis do to be able to continue driving safely and comfortably? “Preparation is the most important thing you can do to make driving with arthritis more comfortable,” says physical therapist Joe Tatta, PT, DPT, founder of the Integrative Pain Science Institute. These tips can help you get prepared.

Drive Safely and Comfortably

Buy the right kind of car

Manual transmissions usually aren’t a good choice for people with arthritis. Instead, the NIH recommends looking for a car with an automatic transmission, power steering, power brakes, and large mirrors.

Adjust the car properly

“The first thing you should always do is make sure to adjust your seat, along with the rear-view and side mirrors,” Tatta says. Angle them in a way to minimize the need to strain or contort yourself, he says.

Take a refresher class

Driving with arthritis — particularly if your condition is advanced — can feel like learning to drive all over again. Even basic skills you’ve been doing for years, like backing up and changing lanes, may need more practice. Taking a class from a Certified Driver Rehabilitation Specialist can help you figure out what physical, mechanical, and mental adjustments you need to keep driving safely and comfortably. They will also teach you how to use any adaptive devices you need to install in your car.

Build in break time during longer drives

Sometimes it’s the duration of the drive that makes things particularly difficult for people with arthritis, so plan to take breaks as often as you need. “There’s the best coffee shop halfway to my office so I always stop there,” says Mark P., of Atlanta, Georgia, who has psoriatic arthritis. “The 15 minutes out of the car and walking helps prevent stiffening up when I get to work.”

Register for a disabled parking permit

Accessible parking can make all the difference between a successful shopping trip and one cut short from pain. “I was in denial about it at first. I thought I should be able to ‘push through’ and walk like everyone else but I’m not like everyone else,” Gemma says. “Getting my sign has been one of the best decisions I’ve ever made.” Getting a placard can be simpler than you think. Here’s everything you need to know about getting a handicap parking permit.

Know when you shouldn’t drive

Even with the best preparation and care, there may be times where your arthritis makes it too difficult to drive. Be honest with yourself about your physical capability, mental fog, and exhaustion. Keep a list of people you can call for a ride if you’re in the midst of a bad flare-up or use a rideshare service to give your joints a rest.

Take Control of Your Steering and Breaking

Get a grippy steering wheel cover

If your arthritis primarily affects the joints in your hands, a steering wheel cover made from a grippy material like rubber or silicone can be a lifesaver, says Tom Ryan, a physical therapist who works with arthritis patients at the Panorama Orthopedics Center, with locations throughout Colorado. This puts less pressure on your hands, requires less grip strength, and can help prevent dangerous slips. Make sure to know what size steering wheel you have before ordering.

Use a spinner knob

Spinner knobs are attachments you can put on your steering wheel that allow you to turn the wheel with less strength and without needing to grip it. There are different options designed for different types of hand disabilities. Read more about different types of spinner knobs and which one might be best for you from Mobility Works.

Have adaptive hand or foot controls installed

For people with severe arthritis in their feet or legs, having hand controls installed may be a good option for driving with more mobility and less pain, Tatta says. These attachments must be custom-fit to you and your car but once they’re in, they allow you to control everything in the car — including the gas and brake pedals — with your hands.

If the range of motion in your legs is limited or you have weakness in your legs, you can also get custom foot controls installed in your car. These can be adjusted for your particular situation, often by lengthening or moving a pedal. Read more about this technology from the National Mobility Equipment Dealers Association (NMEDA).

Such mobility controls can be game-changing by making it possible for people with many different kinds of severe disabilities — from amputations to neuromuscular diseases — to stay active and independent. But know that they aren’t a DIY fix. For starters, hand and foot controls must be installed by a professional and can be quite expensive. They can range from hundreds to thousands of dollars (and up) for the equipment alone, plus additional costs for mandatory evaluation, installation, and training lessons. The NMEDA is a great place to start to research authorized dealers, installers, and classes: Visit the NDMEA site or call (866) 948-8341.

Take Your Seat to the Next Level

Sit on a heated chair cover

A padded, heated chair cover can make all the difference between a comfortable drive and a crippling one. The heat can help keep your joints and muscles loose while the padding is supportive. “I’m a long-haul trucker and I couldn’t do my job without my special seat cover,” says Stan H., of Grand Rapids, Michigan, who has osteoarthritis in his knees and spine.

Try a lumbar-support pillow

For people whose pain is mainly in their back or hips, a lumbar support pillow can make a big difference, Ryan says. This half-moon shaped pillow sits right at your lower back and supports proper posture and spinal alignment.

Sit on a ‘doughnut’

If sciatica, hip, or tailbone pain bothers you, an ergonomic seat pillow (also sometimes called a doughnut) can offer support while relieving pressure in those areas, Ryan says. Look for one made from memory foam or gel as it will keep its shape longer and offer firmer support than ones made from traditional padding. “I carry my ‘butt pillow’ with me to any place I’ll have to sit. It makes that much of a difference,” says Rachel R., of Pasadena, California, who has rheumatoid arthritis.

Put in a center console armrest

The armrests in cars are often too hard, low, or narrow, or are just not practical for people with arthritis in their wrists, elbows, and shoulders. Remedy this with a luxe padded arm rest that you can strap over the existing arm rest. “It’s very comfortable and also has extra pockets so I don’t have to reach around for things,” says Michelle A., of Las Cruces, New Mexico, who has lupus.

Use strategically placed towels

If you’re driving someone else’s car or you don’t have the cash to invest in specialized car seat adjusters, rolled towels can be a good alternative, Tatta says. Try putting a rolled or folded bath towel behind your back or shoulders or use a rolled hand towel behind your neck or under your elbows to reduce pressure and provide extra support.

Trick Out Your Ride with Other Adaptive Devices

Carry a portable grab bar

You may already have grab bars in your bathroom or bedroom at home, but did you know they make them for cars as well? This portable vehicle grab bar is small enough to fit in a purse or glove box and is super easy to use. Simply wedge it in the latch hole in your door frame and it makes getting in and out of your car much safer and simpler. “This was the best gift I ever got,” Stan says.

Install a support handle

If the small grab bar isn’t enough, try a hanging support handle. It gives you a wide grip and steady support while getting in and out of your car, Ryan says. The strap is adjustable for your height and it is lightweight and can be easily packed away when you don’t need it.

Get a grippy key topper

“I’ve dropped my car key an embarrassing number of times,” Michelle says. “These silicone key covers are a staple now.” They serve two purposes: helping you hold the slippery thing while putting it in or taking it out of the ignition and helping you find your key more easily if it does slip out of your grip, she says.

Use a car key turner

Getting the key in the ignition can be tricky enough if you have arthritis in your hands but turning it can be a real shock of pain. Make it easier by using a car key turner tool, Ryan says. “It requires less force to turn the key and gives you a much larger surface to hold,” he explains.

Put on a seat belt ID

People with arthritis often have complicated medical histories. This information is vital to your getting proper treatment in case of an accident or other emergency situation, says rheumatologist Anca Askanase, MD, director of rheumatology clinical trials at Columbia University Medical Center. This simple fabric seat belt ID band attaches to the part of your seatbelt that crosses your chest and contains all the information emergency responders need to know about your health history to give you appropriate care. Customize it with whatever details you feel are most important, including things like medications, blood type, and surgeries.

Slide a buckle band on your seat belt

Trying to fish out the receiving end of the seat belt when it’s gotten wedged or twisted between the seats is a lesson in pain and frustration. Make it easier by sliding a buckle band around the bottom part of the seat belt, Ryan suggests. It keeps it upright and properly positioned so all you have to do is click and go. The stretchy silicone allows it to fit most seatbelts and makes it easier to hold on to. “I’ve put these on all the seat belts of all our cars, they are a necessity, not a luxury,” says Mason M., of Chandler, Arizona, who has ankylosing spondylitis.

Keep an unbuckler handy

Travel with kids in car seats? Make sure you have the UnbuckleMe handy, Ryan says. It slides over the release button on the child’s seat belt, allowing you to open it without pain. Once you’ve used it, make sure to store it out of reach of the child — they’re quick learners and the last thing you need is a toddler on the loose while you’re driving! The BuckleBee is a similar tool but helps release traditional seat belts more easily.

Take Care of Your Health

Treat your disease properly

The more pain and swelling you have, the harder driving (and everything, really) is going to be so do the best you can to maintain the health of your joints, says Dr. Askanase. This should include taking your medications as directed, eating an anti-inflammatory diet, getting regular exercise and sleep, and doing any recommended physical or occupational therapy.

If you find that driving is becoming increasingly difficult due to, say, reduced flexibility in your neck or unrelenting stiffness in your fingers, you need to let your doctor know, as this could be a sign that your current treatment is not working hard enough for you. Jed F., who has ankylosing spondylitis, realized he needed to be more aggressive about his treatment when his back and neck pain got so bad that it became difficult to drive safely. “Before I sought treatment, I could not turn my head to the left at all,” he says, “which made driving dangerous because I could not check my blind spots and I was getting scared.” Escalating to a biologic therapy made a big difference in his comfort while driving. Watch more of Jed’s story here.

Exercise daily

Having a good level of fitness is important for driving. It takes strength, flexibility, and a certain level of conditioning to operate a car, particularly for long periods of time, Dr. Askanase says. Daily exercise can help you maintain that necessary fitness. Make sure to remember to exercise the muscles you use for driving, including the ones in your hands and feet, Tatta adds.

Practice some stretches

If your muscles cramp, pain becomes intense, or fatigue starts to take over while you’re driving, pull over and take a quick break. Step outside your car, get some fresh air, and do some gentle stretches to get the blood flowing back to your joints. “I do stretching exercises 10 minutes before I get in my car,” Mark says. “Just a little loosening up prior to driving makes a big difference for me.”

Wear compression socks

Compression socks are designed to keep blood from pooling in your feet and legs while providing extra support. “I swear by really tight compression socks, especially if I’ll be in the car for more than an hour,” says Amy P., of Denver, Colorado, who has reactive arthritis and fibromyalgia. Bonus: They come in a wide variety of fun colors and patterns, which may not make your drive easier but will certainly make it more fun. Read more here about the benefits of compression socks for arthritis.

Swap out your shoes

Bethany L., of Brisbane, Australia, discovered early on that her 30-minute commute was miserable thanks to rheumatoid arthritis pain in her ankles. “It felt like I was literally grinding the bones together every time I pushed the gas,” she explains. But when she would go hiking, she realized she didn’t have the same problem. The difference was in her footwear: Her hiking boots have firm ankle support while her work shoes don’t. Her solution: “I always wear my boots to drive now and change my shoes when I get to work.”

Learn some relaxation exercises

If you feel tense driving through bad traffic or weather, then your body is definitely feeling it too, says Susan Blum, MD, MPH, assistant clinical professor in the department of preventive medicine at the Icahn School of Medicine at Mount Sinai in New York City. That stress can manifest in clenched hands, tight shoulders, gritted teeth, and headaches. All of these things can exacerbate arthritis symptoms, so learning how to calm yourself in the moment is key, she says. Even a few slow, deep breaths will help.

Keep Reading

Adaptive Methods of Accelerating and Braking. National Mobility Equipment Dealers Association. https://nmeda.com/what-to-buy/acceleration-and-brakes.

Busteed S, et al. Rheumatoid arthritis impairs driving ability even in patients with a low disability index. Rheumatology. January 2004. doi: https://doi.org/10.1093/rheumatology/keg455.

Cranney AB, et al. Driving problems in patients with rheumatoid arthritis. The Journal of Rheumatology. December 2005. https://www.ncbi.nlm.nih.gov/pubmed/16331759.

Interview with Anca D. Askanase, MD, MPH, rheumatologist at Columbia University Irving Medical Center

Interview with Joe Tatta, PT, DPT, founder of the Integrative Pain Science Institute

Interview with Susan Blum, MD, MPH, founder and director of Blum Center for Health

Interview with Tom Ryan, PT, Panorama Orthopedics Center

Older Drivers. National Institute on Aging. https://www.nia.nih.gov/health/older-drivers.

Steering Wheel Spinner Knobs and Driving Aids. MobilityWorks. https://www.mobilityworks.com/hand-controls/spinner-knobs.

 Vrkljan BH, et al. Supporting Safe Driving with Arthritis: Developing a Driving Toolkit for Clinical Practice and Consumer Use. The American Journal of Occupational Therapy. March 2010. doi: https://doi.org/10.5014/ajot.64.2.259.

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