Most people with multiple sclerosis keep driving. That is worth saying first, because a new diagnosis tends to arrive with a long list of things you are worried about losing, and driving is often near the top of it.
MS is unpredictable, and that is really the whole issue. It is not that MS makes driving impossible. It is that MS can change month to month, and the driving question has to be revisited as things change rather than answered once.
This article explains how it works in Queensland.
Do I have to tell Transport and Main Roads?
Yes, if your MS is likely to affect your driving.
In Queensland you have a legal responsibility to report a permanent or long-term medical condition that affects your ability to drive safely. You also have to report if a condition you already reported has got worse in a lasting way.
That second part matters with MS. If you reported at diagnosis and things have since changed, that is a new report, not a one-off.
Reporting is done through TMR's online notification service or with a medical condition notification (Form F4355). You will also need a Medical Certificate for Drivers from your GP or neurologist. See the Queensland Government reporting page or our walkthrough in reporting a medical condition to Queensland Transport.
How MS can affect driving
Not everyone gets all of these, and many people get none of them to a degree that matters. But these are the ones we look at.
Fatigue. The most common symptom in MS, and the one most likely to affect driving. This is not ordinary tiredness. It can arrive suddenly, it gets worse in heat, and it affects concentration and reaction time before you feel obviously sleepy. On the Gold Coast, the heat point is not academic. A drive that is fine in July can be much harder in February.
Vision. Optic neuritis can cause blurred vision, loss of colour, or pain with eye movement, usually in one eye and usually temporary. Double vision can also occur. Neither is compatible with driving while it is happening, and both usually settle.
Muscle weakness and spasticity. Affects how quickly and accurately you move between pedals, how firmly you can brake, and how steadily you hold the wheel.
Numbness and reduced sensation. If you cannot feel the pedal properly, you cannot judge how hard you are pressing it. People often adapt to this without realising, which works until it does not.
Coordination and tremor. Affects fine steering control and smoothness.
Thinking speed. Around half of people with MS notice some change in processing speed, attention or memory. It is usually subtle. In driving it shows up as taking slightly longer to react at intersections or in unfamiliar traffic. We have explained what this involves in how cognitive skills affect driving.
Heat sensitivity. Many people with MS find their symptoms temporarily worsen when overheated. A car that has been in the sun at Robina Town Centre for two hours is a genuine trigger.
Relapses
If you are in a relapse, you should not be driving until it has settled and your neurologist says you are right to go back.
This is not a technicality. During a relapse your vision, strength, coordination and fatigue can all be significantly worse than your usual baseline, and it can come on over days.
After a relapse, most people return to driving without any formal process. Where a relapse has left a lasting change, that is when reporting and possibly an assessment come in.
Where does an OT driving assessment fit in?
Many people with MS never need one. Their neurologist confirms they are fit, TMR issues a conditional licence with a review date, and that is that.
An assessment becomes useful when:
Symptoms have changed and you or your doctor are unsure what it means for driving
Fatigue is affecting your concentration, and you want an honest read on how far and how long you can safely drive
You are wondering whether hand controls or other modifications would help
Weakness or coordination has changed enough that using the pedals is harder
TMR has asked for a practical assessment before deciding on your licence
You want to keep driving and want a documented, defensible basis for it
That last one is under-rated. An assessment is not only a gate. For a lot of people it is the evidence that lets them keep going with confidence.
What the assessment involves
Two parts, about three hours in total.
The off-road part happens at home. Medical history, medications, vision screen, physical movement, strength and coordination, then tasks looking at attention, processing speed and planning.
The on-road part is in a dual-control car with a specialist driving instructor and the occupational therapist, in your own local area. If modifications look useful, we can trial them during the drive.
Two things worth doing for an MS assessment specifically. Book it for the time of day you feel at your best, and tell us honestly where your fatigue sits, because an assessment that catches you at your sharpest gives you a less useful answer than one that reflects your real week. What to expect on the day covers the rest.
Modifications that help
Where the difficulty is physical, small changes often solve it.
Hand controls remove the legs from the equation entirely, which suits people with lower limb weakness or reduced sensation. A steering aid gives you accurate steering with one hand. Secondary control extensions let you reach indicators and wipers without letting go. Seat and mirror changes are minor and often make the largest difference to fatigue over a long drive.
The order matters: assessment, then prescription, then installation, then TMR updates your licence. Do not buy first. Full detail in vehicle modifications for drivers in Queensland.
Practical things that help regardless
Drive when you are freshest, which for most people with MS is earlier in the day. Keep drives shorter and break long ones up. Pre-cool the car. Park in shade where you can. Avoid driving straight after physiotherapy, a hot shower or anything else that has raised your body temperature.
And treat a change in how driving feels as information rather than as something to push through. Noticing early gives you options. Noticing late narrows them.
Frequently asked questions
Will I lose my licence because I have MS?
A diagnosis by itself does not cost you a licence. Most people with MS continue to drive, often on a conditional licence with a review date attached.
How often will I be reviewed?
TMR sets the interval based on your doctor's advice. Because MS can change, annual review is common. It is not a re-test, it is a medical check-in.
Can I drive during a relapse?
Not until it has settled and your neurologist supports your return. Vision changes and sudden fatigue during a relapse are a real crash risk.
Does my MS medication affect driving?
Some do, particularly ones causing drowsiness, dizziness or blurred vision, and particularly when starting or changing a dose. Ask your neurologist directly. More general information in driving and medications.
Can NDIS fund a driving assessment?
Yes, for participants with MS whose plan includes relevant capacity building supports. We work with self-managed and plan-managed participants. Options are set out in OT driving assessment cost in Queensland.
I use a wheelchair some of the time. Can I still drive?
Possibly. Many wheelchair users drive with modifications. The assessment looks at transfers, stowing your chair and using the controls, and works out what would be needed.
Ready to book an OT driving assessment on the Gold Coast? Steer Driving is a mobile assessment service covering the Gold Coast and surrounding areas. Whether you already have a referral or you're just getting started, get in touch and we'll guide you through the next steps.
This article was written by Elise, an AHPRA-registered Occupational Therapist and driver assessor. Elise is the founder of Steer Driving, a mobile OT driving assessment practice.
References
Austroads. (2022). Assessing fitness to drive for commercial and private vehicle drivers (6th ed.). Austroads. https://austroads.gov.au/publications/assessing-fitness-to-drive/ap-g56/neurological-conditions/other-neurological-and-neurodevelopmental-conditions
Queensland Government. (2024). Reporting your medical condition. Department of Transport and Main Roads. https://www.qld.gov.au/transport/licensing/healthy-to-drive/report-medical-condition
