Driving with joint pain and stiffness can be a challenge. But rheumatoid arthritis (RA) shouldn’t keep you off the road. There are steps you can take to make your ride easier. What can you do?

“The modifications are endless,” says Eron Bozec, an occupational therapist with the Driver Rehabilitation Program at Marianjoy Rehabilitation Hospital in Wheaton, IL.

Here are some RA-friendly driving tips for your next trip.

Adjust Your Seat

There are many ways you can “get your car to fit you,” Bozec says. A big one is to set your seat at a comfy distance from the gas and brake pedals so you don’t have to reach too far.

For example, Lynn Marie Witt is tall. The former occupational therapist pulls her seat closer to the steering wheel so that she can press the pedals with her whole foot. That eases strain and fatigue on the small joints in her toes.

That’s a good fix, says Bozec; just try to leave at least 10 inches of space between you and the wheel for safety reasons.

Other things that can help include:

  • Raise your seat for a better view over the dashboard.
  • Add armrests for support on both sides.
  • Use back support to keep your spine in a good position.
  • Use heated seats to ease pain and stiffness in your hips and back.
  • Sit on a cushion for support.

Witt sometimes uses a swivel seat. That’s a portable cushion that spins in a circle so that you don’t have to turn from the hips as much when you enter and exit your car.

There are lots of swivel seats on the market. Witt’s cost $15 at her local grocery store. If you don’t want to buy one, try sitting on something slippery like a plastic garbage bag.

“It really works well and helps you glide into and out of the seat with much more ease,” Witt says

Modify Your Steering Wheel

RA affects different people in different ways, but it’s common to have problems with grip. Here are some tips to help you grip the steering wheel when you drive:

  • Adjust the tilt and telescope. This feature comes standard in most vehicles. It lets you raise and lower the steering wheel. You can usually pull it close or push it farther away. Adjust it to find a comfortable position for you.
  • Think about where your hands go. If the traditional 10 and 2 grip positions (like positions on an analog clock) cause pain in your shoulders, try 9 and 3. “[It] might be a little more comfortable, especially for long drives,” says Christina Hanson, an occupational therapist and teacher at Marianjoy Rehabilitation Hospital.
  • Add a padded steering wheel cover. It can make it easier to grip. Witt uses a cover for comfort. But it also keeps her steering wheel from getting too hot or cold. “I’m very temperature-sensitive in my hands,” she says.
  • Use a spinner knob. You can attach one of these to your steering wheel. It helps you turn the wheel while using less strength. These devices often look like a doorknob. But they come in other shapes that might work better for you. Check to see if your state has special rules about steering wheel changes, like adding a spinner knob. You may need special approval.

Use RA-Friendly Features

Witt carries a portable steel handle to get in and out of her car. You may see these called a “vehicle grab bar” or HandyBar. You insert them into the U-shaped door latch attached to your car that is exposed when you open your car door. Once it’s inserted, you can push down on the handle to help support your weight as you stand up or sit down. “These little devices can hold a lot of weight,” Witt says.

You also may benefit from other low-tech add-ons, including:

  • An extension to help turn your key
  • Blind spot mirrors
  • Tools to help you open and close the door
  • Turn signal extenders

Lots of modern vehicles come with tools to help drivers. They’re not made specifically for people with RA, but the following may help:

  • Push-button start
  • Regular or adaptive cruise control
  • Backup cameras
  • Big mirrors
  • Parallel parking guides
  • Blind-spot alerts

Time Your Trip

Driver fatigue can set in fast when you have RA. It’s key to hit the road when you’re most alert. And make sure to keep up with your RA treatment. It’ll likely be easier to drive when your symptoms are under control.

You’ll need to go over any medication side effects with your doctor. Your treatment may not impair driving. But some drugs used to ease RA symptoms might cause:

  • Trouble remembering
  • Trouble thinking
  • Slowed reaction time
  • Drowsiness

It might be OK to take nonsteroidal anti-inflammatory drugs (NSAIDs) before you hit the road. But that’s something you should talk to your rheumatologist or regular doctor about. They’ll let you know what’s safe to use while driving.

Stop to Stretch

Your joints may hurt more when you don’t move for a while. That’s partly because of a lack of blood flow, Bozec says. But pain and stiffness from RA can make it hard to sit for long periods.

You may feel better if you change positions while you drive. But you also should plan pit stops along your route. Get out and move around for at least a few minutes.

How often should you take breaks? It depends on how RA affects your body. “Some people may be able to hold the steering wheel longer than others,” Bozec says. “Some people may get pain in their legs and need to get out and stretch more often.”

Whitt gets out of the car at least every 1-2 hours. She may stop and do gentle stretches every 45 minutes during a flare. “Otherwise, I would stiffen, and joints would lock out,” she says.

Here are some RA-friendly moves to try at your next rest stop:

  • Roll your head five times to the right and left.
  • Flex and point each foot 10 times.
  • Draw a circle with your foot five times in each direction.
  • March in place 10 times.
  • Roll your shoulders forward and backward 10 times.

While driving, remember to open and close your fingers every now and then. And roll your wrists one at a time. “But don’t let go of the wheel,” Hanson says.

Talk to a Professional

A regular occupational therapist is a good start. They’ll be able to give you everyday tips on back support, cushions, seat positions, and other ways to protect your joints.

But if you need special equipment or want to know how RA impacts your overall driving, “I would suggest seeing a driving rehab specialist,” Bozec says.

There are several ways these experts can figure out your specific needs. For starters, they’ll put you in a car and watch you drive. That’ll help them gauge your muscle strength, reaction time, and mobility issues.

But they’ll also ask you questions, such as:

  • How does arthritis affect your daily life?
  • Are you on treatment to control your symptoms?
  • Can you turn your head to check your blind spot?
  • Is it easy to put your seatbelt on?
  • Do you have a hard time pushing the pedals?

A driver rehab specialist can also help you get permission to use adaptive equipment. “They would be versed in all the rules and regulations for that specific state,” Bozec says.

Your doctor may work with a driver rehab program. But you can search the Association for Driver Rehabilitation Specialists website or the American Occupational Therapy Association website for a specialist in your area.