Professional drivers’ hand and arm problems come from the cab and from the curb.
In the cab: an ELBOW RESTING BENT on the window ledge squeezes the ulnar nerve, and hours of gripping the wheel with bent wrists feed carpal tunnel syndrome.
At the curb: parcels, crates, ratchet straps, tail lifts and cab steps cause tendon pain, crushed fingers and wrist fractures from falls. Arm position and a few handling habits prevent most of it.
What the job asks of your hands
- The window ledge. An elbow bent and resting on a hard edge for hours presses on the ulnar nerve, and bending the elbow stretches it at the same time
- The wheel. Hours of grip, often one hand on top with the wrist bent, and a tighter grip in traffic, rain and fatigue
- Vibration. Through the wheel and seat, all shift
- Delivery work. Hundreds of parcels a day, lifted, carried, scanned and posted through doors
- Trucks. Ratchet straps, curtain buckles, fifth-wheel release handles, tail lifts and heavy doors
- Cab steps. Climbing down backwards in the dark and rain, often jumping the last step
- The phone. Tapping a mounted phone with an outstretched thumb between jobs
Ring and little fingers going numb on long drives: take your elbow off the window.
What turns up
- Tingling in the ring and little fingers, worse on long drives and at night: cubital tunnel syndrome
- Night numbness in the thumb, index and middle fingers: carpal tunnel syndrome. The night pattern tells you which nerve
- Thumb-side wrist pain lifting parcels with the thumb up: De Quervain’s
- Outer elbow pain from ratchets, crates and doors: tennis elbow
- A finger that catches after years of gripping: trigger finger
- Aching at the base of the thumb from buckles and phone use: thumb base overload, or CMC arthritis
- A fall from the cab onto a hand: wrist fracture or scaphoid fracture
- Fingers trapped in tail lifts, doors and shutters: crush injuries and crushed fingertips
The changes that make the most difference
- Arm off the window ledge. If you rest the elbow, rest it straighter, on padding, and change position often
- Hands low on the wheel with a light grip, and wrists close to straight. Move the seat so your elbows stay slightly bent instead of reaching
- Pad the elbow at night if ring and little fingers tingle. A towel wrapped loosely around the elbow stops it bending fully while you sleep
- Use the sack truck or trolley for multi-parcel drops, and carry close to your body, palms up
- Three points of contact on cab steps, facing the cab, every time. No jumping the last step
- Keep hands clear of tail lift edges and closing doors, and wear gloves for strapping and curtain work
- Voice commands instead of thumb-tapping a mounted phone
- At every break, open your hands, straighten your elbows and let the arms hang
A realistic timeline
- Weeks 1 to 2: elbow off the ledge, grip lower and lighter, night elbow padding or a wrist splint depending on which fingers tingle
- Weeks 2 to 6: intermittent nerve symptoms ease for most people over this window once the position changes. Add tendon loading for elbow pain
- Week 6: no change, or numbness becoming constant, means an assessment
Get it assessed if
- Numbness that no longer comes and goes
- Weakness: dropping things, clumsy fingers, trouble with buttons
- A hollow appearing between the thumb and index finger
- Thumb-side wrist pain after a fall from the cab, even with a normal X-ray
- A finger that locks
Driving with a cast or splint after an injury is a separate question.
See driving after a hand injury.
Riders have their own version in motorcycling, and warehouse work in warehouse and logistics.
For the splints involved, see the cubital tunnel night splint and the carpal tunnel night splint.
Elbow off the ledge, hands low and loose, and three points of contact on the steps.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.