Simplifying the path for individuals experiencing continuous discomfort while driving
Chronic pain, a common condition that can take the form of persistent migraines, arthritis, back pain, or pain following surgery, affects one in five GP consultations in Australia. With 14% of Australians (3.5 million people) suffering from chronic pain, it's essential to address the challenges it poses for driving.
Assessing and Managing Chronic Pain
A thorough, individualized assessment of chronic pain is crucial, integrating evidence-based strategies such as self-management education and graded sensorimotor retraining to reduce pain and disability. This approach supports more informed clinical decision-making tailored to the patient’s needs and context.
Ongoing communication and education during patient encounters are also vital, emphasizing transparency about treatment goals and effects, particularly concerning how medications or therapies may impair driving ability. Health professionals are encouraged to discuss these aspects clearly with patients and their families to maintain safety and adherence to legal obligations.
Medication and Driving
The effects of medications, including those from medicinal cannabis or opioids, should be carefully considered as they may have driving restrictions due to impairment risks. Australian laws prohibit driving with THC in the system, and this factor should be explicitly addressed in treatment planning and patient counselling.
Multidisciplinary Approach
A multidisciplinary approach involving pain specialists, anaesthetists, nurses, physiotherapists, and other healthcare providers is essential to collectively manage chronic pain while assessing functional capabilities, including driving fitness.
Practical Tips for Drivers
Sitting forward to reach the pedals and adjusting the steering wheel for comfort are recommended adjustments for drivers with chronic pain. Long trips can aggravate pain, and drivers should take breaks at least once an hour to stretch, massage tight muscles, and check local sights.
A physiotherapist can help with increasing and maintaining movement and muscle strength through a tailored exercise program and pain-relief techniques. Pain Australia suggests exercise as a self-management technique for sufferers of chronic pain.
The Role of Health Professionals
Health professionals are urged to assess the patient’s pain, function, and cognitive status comprehensively, educate patients on the interactions between chronic pain, medications, and driving risks, coordinate care with specialists when complex decisions about driving fitness arise, and document findings and recommendations regarding driving clearly.
RACV Research and the NTC Review
RACV research, which will be part of RACV's submission to the National Transport Commission (NTC) review, has found that health professionals need clearer guidelines on treating chronic pain in order to help motorists manage their pain. The NTC is seeking input from various sectors, including the medical community, patient representative bodies, industry, public health, and transport agencies, on its review.
[1] Australian Pain Management Association (APMA) – Best Practice Guidelines for the Management of Persistent Pain [2] Australian Commission on Safety and Quality in Health Care – National Safety and Quality Health Service Standards [3] Australian and New Zealand College of Anaesthetists (ANZCA) – Pain Management [4] National Drug and Alcohol Research Centre (NDARC) – Driving under the influence of drugs [5] National Transport Commission (NTC) – Assessing Fitness to Drive Guidelines
- Given the wide-ranging impacts of chronic pain, it's imperative for healthcare professionals to incorporate strategies that promote health-and-wellness, such as self-management education for pain reduction, into the treatment plan. Moreover, fitness-and-exercise interventions, like physiotherapy-guided exercises, could be beneficial for enhancing movement and muscle strength, thus helping manage chronic pain effectively.
- In the process of comprehensively assessing the driving fitness of a patient suffering from chronic pain, health professionals should consider the effects of medications on driving ability and adhere to relevant laws, such as the prohibition of driving with THC in the system. Discussing these aspects clearly with patients and their families would not only maintain safety but also ensure compliance with legal obligations.
