(Updated With 3 New Tips)
Driving with sciatica and piriformis syndrome can wreak havoc on people and the poor design of car seats simply adds to the problem.
Car seats are not well designed ergonomically, which is fine for people who live free of pain.
But for those who experience pain while driving with sciatica and piriformis syndrome, getting into a car seat is like sitting into an iron maiden.
I learned about sciatica and piriformis syndrome intimately when my body broke down and I ended up in physical therapy for a year.
Even though I am not a sciatica sufferer, hour after hour behind the wheel can still put terrible demands on my body and I devised a number of strategies for driving and surviving.
I hope they help.
The following driving tips are for anyone and everyone, but will especially serve those who are troubled by nerve issues in the lower spine and pelvis.
Tips For Driving With Sciatica And Piriformis Syndrome
1- Getting in and out of a Car When You Have Sciatica
To avoid sciatica while driving you have to start the journey correctly.
Unfortunately, the pain from sciatica and piriformis syndrome can be triggered before you turn the car on.
The sciatic nerve passes through the pelvis so keeping the pelvis well aligned is super important.
The function of the piriformis muscle is to turn the leg out and pull the leg to the side when the hip is flexed. Which is the exact act of getting in and out of a car.
I often return to those annoying people who don’t suffer from pain. They get in and out of a car without thinking about it.
One leg goes in spreading the legs wide which can tweak the sciatic nerve and piriformis muscle.
Getting out of the car is the same in reverse. One leg out and then the other.
A serious problem with sciatic nerve pain is that once the pain kicks in you have lost the battle if not the war.
While changing habits is not easy pain is a great incentive.
So here is your new way to get in and out of a car.
- Sit in the car seat sideways with the legs together and the feet on the ground.
- Keeping the legs together, swivel both legs into the car at once.
- Get out the same way keeping the legs together the whole time.
By keeping the legs together and the pelvis aligned, there is less chance to mess with the sciatic nerve.
And if you start your drive without pain you just might stay that way.
2- Left Foot On The Foot Pad
Keep your left foot on the rubber pedal that is a feature in every car.
This allows both legs to be in relatively the same position which gives you the best chance to maintain a balanced pelvis.
Your knee will be bent slightly depending on how near or far from the steering wheel your seat is situated.
People adjust their seats for different reasons (See Tip #6 ) but I don’t think it is great to be too close to the steering wheel, and giving the legs a little room to lengthen is a good choice.
There are a number of bad choices available for the left leg.
Keeping the foot flat on the floorboard, with the knee bent, instead of on the pedal creates a hip flexion that would be better off to avoid.
I have also seen people crossing the left foot both over and under the right thigh. Don’t do that!
It’s best to be nice to your left leg and keep your left foot on the pedal provided.
3- Right Heel Under the Gas Pedal
The right foot should be parallel as much as possible.
There is a tendency for the heel of the right foot to live between the gas and brake pedals, allowing the foot to pivot between the two.
Over many hours, or even minutes for some, this slight external rotation can tweak the piriformis.
Especially when going to use the brake after a long time on the gas pedal.
It is best to keep the heel directly in line with the bottom of the gas pedal and shift the whole foot and leg to the brake, and then back to the gas, maintaining a parallel alignment of the right foot.
4- Hands At Nine And Three
You might not think that your arms are involved when driving with sciatica and piriformis syndrome but…
If you hold your hands at nine o’clock and three o’clock on the steering wheel you are balancing the sides of your trunk.
Just like keeping the left leg in a similar position to the right, both hands on the steering well creates the best environment for the pelvis to preserve a balanced position.
Driving one handed should be avoided because it allows for assorted misalignments and permutations of the trunk because the arms are free to perform two completely different actions.
Looking at the archetype of the American male driver—right hand on the top of the wheel and the left elbow resting out an open window, this position tends to lengthen the right side and shorten the left.
Switch sides and put the left hand on the wheel and the right elbow on the middle console and you will likely collapse the right side a bit.
Your best option is to keep your hands at nine o’clock and three o’clock and treat the sides of your waist, and your sciatic nerve kindly.
5- A Curve in the Lower Back
Keeping a curve in the lower spine is a challenge anytime you sit in a car.
The pelvis wants to tuck and the lower back tends to meld with the seat back.
Every effort to avoid this and any attempt to find the best position for the spine can pay great dividends.
The ability to find this posture requires core muscle tone that some people have and others need to develop.
The resting muscle tone that we have before we get into the car determines how long we can drive in an optimal position once we are on the road.
If you don’t have the muscle tone and strength required you might actually need to fake it before you make it so that you can keep your lower spine curved in the correct way.
Once we lose the alignment of the spine and/or tuck the pelvis we are putting the sciatic nerve and piriformis muscle into a very vulnerable position.
6- Head On the Headrest
Headrests in cars (especially newer models) are positioned to protect against whiplash in an accident.
Unfortunately that shoves your head forward and trust me when I tell you that your forward head was a problem before you got in the care.
The design might be intended to reduce whiplash injuries but the cost to the position of our head and neck is not in any way worth it to me.
But no matter where your headrest resides, the back of your head should be against it, lengthening the back of the neck so that your eyes are level and you can maintain your gaze level with the horizon line.
7- Adjust Your Seat (A Little)
In Tip #1 I said you should distance your seat so your leg has room to extend comfortably.
This remains true but when it comes to pain, stillness is often an adversary.
I can’t tell you the number of injuries that occur after we sit or stand too long and then move.
To avoid this, especially on long trips, find a position you like and after 30 minutes slide the seat 1 setting forward.
After another 30 minutes, take the seat back 2 settings.
After another 30 minutes, return to your preferred position.
8- The Cabbie Solution
This tip doesn’t appeal to everyone's aesthetic sense but function over form should win out when it comes to pain relief.
A soft seat that welcomes us to sink deep into it does not serve us well.
And while it might seem counterintuitive to think putting your butt on a hard surface will help with lower back and butt pain, that hard surface will allow you to find, and maintain, much better alignment.
9- A Tennis Ball
You can make great use of a tennis ball while driving.
You can sit on it which can bring relief to your butt and piriformis muscle.
You can put it behind your back in any of many positions which can also be helpful.
Rolling out your feet with the tennis ball is great but particular to people in the passenger seat.
You shouldn't roll your foot out while driving because you can lose contact with the ball and it can roll and get stuck under the gas pedal.
And we wouldn't want that.
If you are driving, stop every hour or so to get out of the car and roll your feet with the tennis ball.
I know this isn't the most convenient option but it is very helpful.
If you are in the passenger seat, roll your feet to your hearts content.
10- Where's Your Wallet?
This is a tip mostly for men and it goes for more than just driving.
No one should keep their wallet in the back pocket.
Especially when sitting and driving.
Get into the habit of carrying your wallet in the front pocket and you will be much happier for it.
Wallets in the back pocket create irritation and imbalance. Don't do it.
******
We are habitual creatures who tend to find a pattern and stick with it.
Unfortunately there is nothing that ensures that our behaviors are for the best.
We don’t naturally choose healthy positive patterns when it comes to movement and posture.
Good patterns will only come with awareness and conscious choice.