Driving and adjusting the car after a spinal cord injury

The car often represents a practical need and allows for a greater degree of autonomy and mobility, which has a particular significance for people with disabilities. The ability to independently drive a car makes you freer when choosing a job and working. Apart from that, many other activities are more accessible to you, and you can participate fully in your family and social life.

Health conditions for driving after a spinal cord injury

Whether you will be able to drive a car after the injury depends primarily on the level of your injury, on whether the injury is complete or incomplete, and on the success of the rehabilitation process. In any case, in order to drive a car, you must have and/or acquire through rehabilitation at least a certain level of control over your hands.

In addition to other health conditions that must be met by all drivers, you must also be able to control muscle spasms which are a common consequence of the spinal cord injury (SCI).

When assessing fitness for driving, every case is examined individually. Most commonly, persons whose injury is in the lumbar spine or the sacral region will be able to drive a car.

Even if you have a higher level of injury, driving a car can still be manageable.

According to a survey conducted in 2001, as many as 84 % of tetraplegics had the ability to drive a car. However, it should be pointed out that you can determine whether driving is possible in your particular case only with your therapist, and if necessary, with other health professionals.

When is the right time to start driving?

First of all, take enough time to recover after the injury — a successful recovery must be your primary focus. Later you will determine with your therapist when you could start driving again, which can be several months after the injury. After all, it is only through rehabilitation that you will be able to determine which changes in the car are needed in the long term to suit your needs.

First-hand tips before adjusting and buying a car

Connect with local associations and their members who have a similar or the same level of injury as you. If they already have the experience of buying or adjusting a car, they can give you valuable first-hand advice and warn you about what to watch out for.

Levels of car adaptation

Technical changes for driving a car after SCI can be divided into the following levels:

  • entering the car;

  • sitting in the car;

  • driving the car.

Where in the car technical changes are needed and to what extent, will depend on your specific needs. The price of the adjustment process will depend on the changes which are needed.

As the price may be extremely high, check your insurance and whether there is any available support from the relevant institutions in your country.

Before you go into any car adjustments, you must determine exactly which changes are necessary according to your needs. In addition, it is crucial that you find a reliable company that will professionally implement the needed adjustments.


Devices used to adapt cars for drivers with SCI fall into the category of so-called auxiliary technologies. These technologies are not only related to car adjustments, their purpose is essentially to ease your disability-related difficulties.

What are the most common adjustments?

Brakes, acceleration and steering wheel

The technical adjustment most often affects those elements of driving a car which require legs, which is understandable as the car is adapted to a person who is paralysed to a certain extent. The parts which are often adjusted are the brake, the gas pedal (accelerator) and sometimes even the steering wheel.

For example, if you are a paraplegic with good hand control, then a car with an automatic transmission might be a good solution for you. In this case, the braking and acceleration mechanism may be adapted for manual control. There are several options for manual control, for example, it can be placed on the steering wheel, and you can adapt it to your specific needs.

You can set the manual brake and acceleration control in a way that you control it with your left or right hand.

If you can use your right leg, then a car with an automatic transmission can be a good solution for you. However, if you can only control your left leg, it will be necessary to adjust and install the gas pedal on the left side.  

The wheel can also be equipped with an accessory which will make it easier for you to handle it with one hand. In addition, if you have a limited hand function, there is also the possibility of installing electronic devices which facilitate handling the steering wheel.

Entering and sitting in the car

For a person with SCI, sometimes an obstacle to driving can be entering the car. In this case, an independent entry can be achieved in two ways: by adjusting the vehicle, usually a larger one like a van, by installing an entrance ramp or a wheelchair crane.

However, it is important that the vehicle can be adjusted in a way that you can drive it while sitting in a wheelchair. For this, it will be necessary to remove the driver’s seat and install a manual or electronic system that will lock and keep the wheelchair in place while driving.

If you can switch from the wheelchair to the driver’s seat independently, you also need to make sure that you choose a car that allows you to bring in and store your wheelchair in it.

Summary — five guidelines for car adaptation after the SCI

If you have decided to drive an adjusted car after rehabilitation, please pay attention to the following:

  1. The level of your injury — largely dictates the adaptation of the car;

  2. Your specific needs — depend mainly on your injury;

  3. Concrete technical changes - you determine them based on your needs and expert assessment;

  4. Type of car - look for the option that best suits the technical customisation requirements;

  5. Financial conditions — before the start of the investment, determine the total cost of the adjustment of the car, keeping in mind your financial possibilities.



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