A driver rehabilitation specialist can help determine whether it is safe for a person with multiple sclerosis (MS) to drive. Some restrictions may apply, such as only being able to drive vehicles with adaptive equipment.

MS can affect a range of skills and abilities required for driving, such as moving between the brake and gas pedals and being able to spot hazards quickly and clearly. These difficulties can lead to an increased risk of having an accident.

For many people, driving may be a way to maintain some of their mobility. Specialized vehicle adaptations can help a person with MS retain their ability to drive safely for longer.

Ultimately, the decision to stop driving is made on an individual basis, with assessment by a team of professionals being an important step.

Keep reading to learn more about driving restrictions for someone with MS.

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An MS diagnosis does not legally oblige a person to stop driving, but there are some factors to consider.

Symptoms and their severity can vary greatly from person to person. Over time, they can affect a person’s reflexes, strength, and mobility, according to the National Institute of Neurological Disorders and Stroke.

While regulations in different U.S. states can vary, most require people to disclose any conditions that could affect their driving ability. This includes having MS.

Are there restrictions?

Some restrictions may apply in certain cases, such as only being able to drive vehicles with adaptive equipment. A person with MS will likely have an evaluation to assess whether driving is safe and whether adjustments need to be made.

Periodic assessments may also be necessary to determine if symptoms have begun to affect driving ability.

Some symptoms associated with MS can negatively affect a person’s driving performance.

MS can cause physical, visual, and cognitive symptoms. A 2021 study reports that having MS can increase a person’s risk of having a traffic accident.

Physical symptoms can affect the muscles. Spasticity, or muscle stiffness or spasms, can increase a person’s risk of having a motor vehicle accident.

Changes in cognition can also increase the risk of an accident. Experiencing changes in cognition can affect:

  • memory
  • the speed at which a person can process information
  • visual-spatial skills, which allow a person to tell where objects are in a given space

In particular, a person may have a reduced ability to drive safely if their MS causes:

  • trouble moving their foot from the gas to the brake pedals
  • trouble getting into or out of a vehicle
  • muscle weakness, cramps, pain, spasms, or stiffness, especially in the arms or right foot
  • loss of sensation in the feet or hands
  • impaired coordination
  • slowed reaction time
  • issues with vision, such as blind spots, blurred or double vision, or loss of color vision
  • fatigue
  • seizures or loss of consciousness
  • medication side effects, such as drowsiness, difficulty concentrating, or poor coordination and reaction time

Cognitive problems that can affect a person’s driving ability include:

  • confusion around starting and stopping the car
  • poor concentration
  • short-term memory loss
  • confusion while driving, such as forgetting the destination, missing exits, or forgetting their location
  • difficulty or inability to multitask

Not everyone with MS will experience all these symptoms or have the same severity.

Some people with MS may only have difficulty driving safely during exacerbations or MS attacks. After overcoming the attack, they may be able to drive safely again. However, for some, MS may permanently affect their ability to drive.

A driver rehabilitation specialist (DRS) is an occupational therapist who can perform a driving evaluation using specialized equipment at a driver rehabilitation clinic. The Association for Driver Rehabilitation Specialists (ADED) provides a directory of qualified DRS professionals.

The assessment usually lasts about 2 hours. It involves an office-based and a behind-the-wheel evaluation.

In-office assessment

During the office-based assessment, the DRS:

  • assesses how MS affects a person’s daily living activities, including bathing, dressing, and managing medication
  • reviews a person’s medical and driving history
  • asks about specific problems the person has with driving
  • asks whether the person has received any tickets while driving, or had accidents or near misses

The DRS also assesses the following:

  • Vision: The DRS will measure visual acuity (sharpness of vision), color vision, depth perception, and ability to recognize road signs.
  • Cognition: The DRS will specifically look at how fast the person’s brain can process information and how MS may be affecting memory and visual-spatial skills.
  • Functions: The DRS will test the person’s strength, coordination, and other vital skills related to driving.

If the DRS is satisfied with the assessment results, they will ask the person to complete the next evaluation.

Behind-the-wheel assessment

This assessment entails a road test, usually starting in quiet traffic areas. The road test aims to check for the following:

  • ability to follow the rules of the road
  • safety awareness while driving
  • ability to transfer safely in and out of the vehicle and stow assistive devices, such as wheelchairs
  • visual searching, scanning, and attention ability
  • reaction time to identify potential hazards
  • reaction time to maneuver the vehicle, and moving their foot between the gas and brake pedals
  • judgment before performing a maneuver
  • ability to multitask
  • ability to stay within their lane and change lanes safely

After the assessment at a driver rehabilitation clinic, the DRS may recommend specialized adaptive equipment for a person’s vehicle. For instance, this may include:

  • adapted mirrors
  • a spinner knob to turn the steering wheel
  • adaptive steering and braking requiring less effort
  • hand controls to replace the gas and brake foot pedals
  • specialized seats to make vehicle transfers easier
  • lifts that allow wheelchairs and assistive devices to be stored easily

A person must pass a road test at their local Department of Motor Vehicles (DMV) to show they can safely use the adaptive equipment.

People with MS who want to drive may have questions about how to find a reputable adapted vehicle dealer and the cost of those adaptations.

A certified dealer needs to install any adaptive vehicle equipment to make sure it is safe. The National Mobility Equipment Dealers Association (NMEDA) lists accredited dealers of adapted vehicles and dealers who install adaptive equipment.

Regarding funding, a person can talk with their DRS to find out their options for financial help to buy a new adapted vehicle or alter their existing vehicle.

Problems with memory, information processing speed, and visual-spatial awareness are some reasons people with MS can have difficulty driving.

MS symptoms can lead to problems getting in and out of a vehicle, impaired coordination, and slower reaction times, to name a few.

That said, MS symptoms and their severity can vary greatly from person to person, so not everyone with MS will experience the same difficulties with driving.

While an MS diagnosis does not legally oblige a person to stop driving, some restrictions exist. An assessment at a driver rehabilitation clinic can help a person identify their challenges and needs. This may then allow them to continue driving using a specially adapted vehicle.