Estimated reading time: 6 minutes
Medically reviewed and verified by Kate Burke, MD, MHA
Getting a car is an important milestone! It represents freedom for many people; the ability to drive where you want, when you want. But for people with multiple sclerosis, driving can get more and more challenging over time. MS affects the nervous system, leading to physical, visual, and cognitive impairments that can impact your ability to drive. Some with MS eventually find themselves with a more advanced form of the disease called secondary-progressive multiple sclerosis (SPMS). As the name suggests, SPMS is a more steadily advancing form of the disease. Instead of patterns of relapse followed by remission, people with SPMS usually see a gradual decline in function. Within SPMS there are a few further types, including non-relapsing (also called non-active) SPMS. nrSPMS will be the focus here. So how does this disease impact your ability to drive? What steps, if any, can you take to stay behind the wheel?
nrSPMS and Driving
To be a good driver takes a combination of physical coordination, mental focus, and sensory awareness. You need to be able to see the road, react to drivers and pedestrians, and understand traffic signals and road signs. Unfortunately, nrSPMS can impact all of these areas.
Vision
A condition like nrSPMS commonly affects the eyes. People with the disease report:
- Blurred vision
- Poor night-time vision
- Blind spots
- Double vision
- Loss of color vision
- Trouble scanning and focusing on moving objects
These changes can make it harder to see hazards, judge distances, and respond to sudden obstacles. All of these increase the risk of an accident.
Cognitive Difficulties
Because MS attacks the central nervous system, issues with cognition are very common. These can include:
- Memory problems
- Confusion
- Difficulty multitasking
- Slower reaction time
- Increased stress and anxiety
You need mental processing speed and decision-making for safe driving. If you find yourself getting lost often or struggling to react in time, your driving ability may be getting worse.
Physical and Motor Function Issues
People with MS often report issues with their motor control. As the nerves are damaged, a wide range of physical symptoms can start to pop up.
- Muscle weakness, stiffness, and spasms
- Numbness or tingling in hands and feet
- Difficulty pressing pedals or turning the steering wheel
- Fatigue
These are physical limitations! Any one of these symptoms can make it harder to drive a car and react quickly in emergency situations.
Signs Driving May No Longer Be Safe
So, what should you keep an eye out for? All the above symptoms can start to arise as nrSPMS progresses. There are certain indicators that operating a motor vehicle might no longer be safe! To start, pay attention to reaction times at traffic lights. When the light turns green, how quickly do you start moving? Are you quick to act when it turns yellow or red? Hesitation or confusion are common as nrSPMS progresses.
When driving down the road, how well are you staying within your lane? Drifting between lanes and having a hard time maintaining position could be a sign of both physical and cognitive decline. Similarly, are you having difficulty judging the distances between cars?
Finally consider your mood. When you need to go out for a drive, how do you feel? Are you confident and sure of your abilities, or do you find yourself feeling overwhelmed? If you find yourself getting lost, even when driving close to home or in familiar areas, that could be a sign that your nrSPMS has started to affect cognition. If you are getting in accidents, minor or major, that is certainly a time to evaluate whether you should continue driving.
What to Do If You're Struggling with Driving
If any of the things above are happening, but you still want to take steps to drive safely, what can you do? To start you may want to consider a driving evaluation. There are people called driver rehabilitation specialists that can look at your driving skills and recommend strategies or adaptive equipment to help you continue driving safely. If your physical limitations are making driving hard, make modifications! Things like hand controls, steering wheel adaptations, or pedal extenders can help improve your ability to drive safely.
You can also try to change some of your driving habits. To start, avoid driving at night or in bad weather. Make sure when you go out you stick to familiar routes and avoid areas like busy highways or congested streets. If possible, plan your trips during low-traffic times. Pulling off the road to take breaks can help a lot! This is a good way to manage fatigue. You should also make sure you reduce distractions inside the car as much as possible. Avoid loud music and put that phone away. It is important to recognize when driving is no longer safe, however. If you are running into significant challenges, talk to your doctor and loved ones about alternative options that may work such as adjusting your medication schedule.
Transitioning from Driver to Passenger
Giving up driving is a hard decision to make. You don't want to feel like you are sacrificing an important piece of your independence, but the reality may be that your nrSPMS has progressed to the point where it is no longer safe to drive a car. That does not mean you have to be house bound! There are ways to stay mobile and independent. You can ask family or friends for rides, and if they are busy use a ride-sharing service like Uber or Lyft. If you live in a city or a well-populated area, public transportation is always available! There are also paratransit services for people with disabilities. Planning for this can make the change easier and less stressful.
Living with SPMS means adapting to changes, and driving is no exception. By staying aware of your abilities, getting professional evaluations, and making adjustments, you can keep your safety and independence for as long as possible! And when the time comes to stop driving, there are still ways to stay active and engaged.
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