You press the accelerator and cannot tell how hard. Your foot feels like it belongs to someone else. Last week you braked harder than you meant to, and your passenger noticed.

Numb or tingling feet are a driving concern. Pedal control depends on feeling and strength, and losing either can make driving unsafe. Some people can still drive with conditions or changes to the car. This article explains how nerve problems affect the pedals, what we check, and what may help.

What is peripheral neuropathy?

Peripheral neuropathy means damage to the nerves outside the brain and spinal cord. It often starts in the feet and hands. You may notice numbness, tingling, burning or weakness.

Many things can cause it, and diabetes is one of the best known. Your doctor works out what is behind yours. If diabetes is part of your picture, read Can You Drive with Diabetes in Queensland?

How does it affect driving?

The national standard, Assessing Fitness to Drive, says that “peripheral neuropathy may impair driving due to difficulties with sensation.” It names a sense called proprioception. That is your brain’s awareness of where your foot is and how hard it is pushing, without you looking. It also names marked weakness. Muscle and nerve-to-muscle disorders can also affect vehicle control.

In the car, that can mean:

• Pressing the accelerator or brake harder or softer than you meant.

• Missing the pedal, or catching two at once.

• Looking down to check where your foot is.

• Slower foot movement between pedals.

• A foot that slips off the pedal, or a leg that tires on a longer drive.

Nerve problems can reach the hands too. If your fingers are numb, steering and controls may feel different. The national standard lists sensation as part of what the upper limbs need to operate the steering wheel and controls.

Does it mean I must stop driving?

Not automatically. For private drivers, the standard says a person is not fit for an unconditional licence if they have neuropathy that significantly impairs muscle power, sensation or coordination. That is the general shape. Your neurologist or doctor works out which side of that line you are on.

For people who do not meet the unconditional standard, a conditional licence may be considered. The standard says that would involve information from your treating doctor, a practical driver assessment if required, and any vehicle modification needed. It says conditional licences for these conditions are subject to at least annual review.

So the honest answer is that some people may be able to keep driving with conditions, and some may not. It depends on how much sensation and strength you have.

Do I have to tell Transport and Main Roads?

If you have a permanent or long-term condition that affects your driving, you have a duty to report it. Your doctor completes a Medical Certificate for Drivers. We explain this in Reporting a Medical Condition to Queensland Transport.

Occasional tingling that does not change how you use the pedals may not meet that bar. Ask your doctor. Do not guess.

What do we check?

We come to your home for the off-road part. We test your vision, thinking skills and physical function. For nerve problems we focus on sensation, leg strength, foot movement speed and coordination, plus grip and hand function if your hands are affected.

For the on-road part, you drive about an hour in a driving instructor’s car, fitted with dual controls. We sit in the back and watch for:

• Smooth versus jerky braking and acceleration.

• Whether you look down at your feet.

• How well you hold speed on gentle slopes.

• Whether you stop safely when something happens ahead.

• Whether your foot or leg tires as the drive goes on.

You can read more in What to Expect on the Day.

If we see a pattern, we name it plainly. If your driving looks safe, we say that too.

What may help?

It depends on what is happening.

• Footwear. Some people find thin, flat-soled shoes help them feel the pedals. Heavy, thick soles can make it harder.

• An automatic car. This removes the clutch and the gear changes.

• Pedal changes. Pedal extensions or a different pedal position suit some drivers.

• Hand controls. For people with significant loss of leg function, the national standard lists hand-operated controls as an example condition.

• Steering aids. Some people with hand problems find these useful.

Changes to the car go through a process. Vehicle Modifications for Drivers in Queensland explains it.

Treatment for the nerve problem itself, and any medicines, are for your doctor.

When you may not need an assessment

If you can feel the pedals clearly, your doctor is happy and nobody has noticed changes in your driving, you may not need one. Stable symptoms that do not affect your control are a good example.

An assessment is worth considering if you are looking down at your feet, braking more heavily than before, your doctor is unsure, or your symptoms are getting worse.