365: Pain Behind the Wheel: An Inductive Content Analysis of Driving with Chronic Low Back Pain

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Other chronic pain category, Psychology, Treatment/management

Background and Aims: Driving is a complex task that requires focus, decision-making, and spatial awareness, all of which can be disrupted by pain. Our previous findings demonstrated that drivers with chronic low back pain (CLBP) frequently experience discomfort from prolonged sitting, movement restrictions, and pain-associated emotional distress, which may significantly affect their driving experience and safety. While existing research links CLBP with objective/quantitative driving deficits, such as delayed response times and increased crash risk, there is a deficit of qualitative research to facilitate a deeper understanding of the lived experiences of drivers with CLBP. In order to address this gap, this study utilized qualitative methods to examine how individuals with CLBP experienced driving-related pain and the strategies they use to cope behind the wheel.

Methods: Eligible adult participants (n = 307) reported CLBP on at least half of the days over a three-month period and had driven within the past week. Participants completed a Qualtrics survey where they were asked (1) “How does pain affect your driving or experiences on the road?” and (2) “What types of things do you do to cope with pain while driving?”. Short answer responses were typed by participants and analyzed using conventional content analysis in N*Vivo by four collaborating analysts.

Results: Analysis revealed three primary interconnected ways that CLBP affected driving. First, attentional effects disrupted individuals’ focus and concentration, resulting in distraction, and slower reaction times. Second, emotional and cognitive effects included frustration, irritability, and anxiety. Third, physical and behavioral effects led to postural changes, fidgeting, and driving avoidance. As such, drivers utilized short-term coping mechanisms to manage impacts on their driving, including attentional redirection through conversation, music, and focusing on the drive, emotional and cognitive strategies via self-talk and relaxation strategies, and physical and behavioral strategies such as movements in the seat, ergonomic adjustments, and taking breaks.

Conclusions: Results suggest that CLBP may influence driving through attentional, emotional, and physical mechanisms, leading to the adoption of coping strategies that may compromise safe driving. Further understanding of pain-related impacts on driving is essential for preventing potential harm arising from the intrusiveness and attentional demands of experiencing pain. Future research should expand these findings by examining the effectiveness of various coping strategies and how they affect real-world driving performance.

References: Sakakibara, T., Kasai, Y., & Uchida, A. (2006). Effects of driving on low back pain. Occupational medicine (Oxford, England), 56(7), 494–496. https://doi.org/10.1093/occmed/kql045

Seward, J., Stavrinos, D., Moore, D., Attridge, N., & Trost, Z. (2021). When driving hurts: characterizing the experience and impact of driving with back pain. Scandinavian journal of pain, 21(3), 445–456. https://doi.org/10.1515/sjpain-2020-0108

Vaezipour, A., Oviedo-Trespalacios, O., Horswill, M., Rod, J. E., Andrews, N., Johnston, V., & Delhomme, P. (2022). Impact of chronic pain on driving behaviour: a systematic review. Pain, 163(3), e401–e416. https://doi.org/10.1097/j.pain.0000000000002388

Presenting Author: Emma Tillery
Submitting Author: Emma Tillery

Senior Author: Zina Trost

IASP 2026 Global Year theme of Neuropathic Pain: No

• Sriram Koneru: B.S. - Texas A&M University
• Emma Tillery: B.S. - Texas A&M University
• Misha Shah: B.S. - Texas A&M University
• Rachel Smet: B.S. - Texas A&M University
• Jackson Gutierrez: B.S. - Texas A&M University
• Nina Attridge: Ph.D - University of Loughborough
• David Moore: Ph.D - Liverpool John Moores University
• Despina Stravinos: Ph.D - University of Alabama
• Zina Trost: Ph.D - Texas A&M University