Written by the Phoenix Rehab physiotherapy and hand therapy teams. Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H; hand, wrist and elbow sections by Nigel Chua, Principal Hand Occupational Therapist & Director, AHPC A1300362Z. Last reviewed 6 October 2026.
The injuries we see most in drivers and delivery riders are lower back pain, neck and shoulder pain, and pain or numbness in the hand and wrist. Hours in the seat, with the vehicle vibrating under you, sit behind most of the back and neck pain. For riders, falls on the road cause the fractures.
A private-hire or taxi shift in Singapore can run ten hours or more. You sit through it with your right foot hovering over the pedals, your wallet in your back pocket, and your head pushed forward to read the phone on the dashboard. Between trips you twist round to lift a passenger’s luggage out of the boot.
Delivery riders have a different day. On and off a motorbike or an e-bike dozens of times, a thermal bag on your back, a kerb to step down with a drink order in one hand, and a wet road in the afternoon rain.
The back pain usually shows up getting out of the car at the end of the shift, not during it. In a UK study of professional truck drivers, 60% reported low back pain.1 Most of it is a load problem we can measure. The fractures from a fall are a doctor’s job first, and ours after.
The shift, and what it loads
| Part of the shift | What it loads | What it most often irritates |
|---|---|---|
| Sitting for hours with the engine’s vibration | Lower back, the discs, the nerves to the legs | Lower back pain, slipped disc, sciatica |
| Head forward to the phone and the mirrors | Neck and the top of the shoulders | Postural neck pain |
| Gripping the steering wheel or handlebars | Wrist and the nerve through it | Carpal tunnel syndrome |
| Twisting to the back seat or the boot | Shoulder and lower back | Rotator cuff, back strain |
| Right leg held bent over the pedals | Front of the knee, buttock | Kneecap pain, deep buttock pain |
| Sitting on a wallet | The buttock and the sciatic nerve under it | Deep buttock pain (piriformis) |
| Loading and carrying parcels and food bags | Lower back, ankles | Back strain, ankle sprain on a kerb |
| Riding a motorbike or e-bike | Wrists, neck, and everything in a fall | Wrist fracture, collarbone and shoulder injuries, knee and ankle fractures |
Every driving and riding injury, by body part
Start from where it hurts. Each row links to the page that covers that injury in full.
| Where | Injury | How driving or riding usually causes it |
|---|---|---|
| Wrist | Carpal tunnel syndrome | Hours gripping the steering wheel or handlebars |
| Wrist | Wrist fracture (distal radius) | A rider putting a hand out in a fall from the bike |
| Wrist | Scaphoid fracture | The same fall, with pain at the base of the thumb that passes for a sprain |
| Shoulder | Rotator cuff tendon pain | Reaching back from the driver’s seat for bags and the back seat |
| Shoulder | Collarbone (clavicle) fracture | Landing on the shoulder in a motorbike fall |
| Shoulder | AC joint sprain or separation | Landing on the point of the shoulder in a motorbike fall |
| Neck | Postural neck pain | The head held forward for a whole shift |
| Neck | Whiplash-type neck sprain | A rear-end collision |
| Lower back | Lower back strain | Long hours seated with the vehicle vibrating |
| Lower back | Slipped disc (lumbar disc herniation) | Sitting for hours, then lifting from the boot |
| Lower back | Sciatica | Sustained sitting |
| Hip and buttock | Deep buttock pain (piriformis or deep gluteal syndrome) | Sitting on a wallet, with the pedal leg held turned out |
| Knee | Kneecap pain (patellofemoral pain) | The pedal leg held bent for hours |
| Knee | Tibial plateau fracture | A motorbike crash with the knee taking the impact |
| Ankle | Ankle fracture | A motorbike crash, or the bike falling onto the leg |
| Ankle | Ankle sprain | Stepping off a kerb with a parcel blocking the view of your feet |
Not on the list, or not sure which row is yours? That is what the first visit is for.
The injuries we see most in drivers and riders
Lower back pain from the seat
What it feels like. Stiffness and an ache across the low back that builds through the shift and peaks when you stand up from the car. Some drivers feel it spread into one buttock or down a leg.
What is usually going on. Sitting for hours keeps the lower back in one position, and the vehicle’s vibration adds a constant small load. The muscles tire and the discs stay under steady pressure. Lifting a heavy suitcase from the boot straight after a long stint is a common moment for a strain or a disc to flare. Pain that runs below the knee with numbness is nerve pain, covered in sciatica.
What we measure. How many minutes you can sit before the pain starts, back movement in each direction, trunk endurance holds in seconds, hip range, and nerve tests in the legs.
This week. Get out of the car every 1 to 2 hours and walk for a few minutes. Wait a couple of minutes after a long drive before lifting anything heavy. Set the seat so your hips sit level with or slightly above your knees, and take your wallet out of your back pocket. Pain relief and anti-inflammatory medication are a decision for your doctor or pharmacist. More on lower back pain.
Neck and shoulder pain, and whiplash
What it feels like. An ache at the base of the neck and across the top of the shoulders by the end of the day, sometimes a headache at the back of the head. After a rear-end collision, neck stiffness and pain that often build over the next day or two.
What is usually going on. A head held forward to the dashboard phone puts the neck muscles under a steady pull for hours. Reaching back into the rear seat with one arm adds a twist. In a collision, the neck is thrown back and forward and the joints and muscles are sprained.
What we measure. Neck rotation each way in degrees, which matters for your shoulder checks, deep neck muscle endurance, shoulder range, and nerve tests in the arms.
This week. Mount the phone at eye level so you look across to it. Get out of the seat and walk round the car to reach the back. After a collision, keep the neck moving gently within comfort. More on neck pain.
Numb fingers on the wheel (carpal tunnel)
What it feels like. Pins and needles in the thumb, index and middle fingers while driving or riding, or waking you at night. Shaking the hand out helps for a while.
What is usually going on. The median nerve runs through a tunnel at the wrist. A firm grip held for hours, with the wrist bent, raises the pressure inside that tunnel. On a motorbike, the throttle hand and the handlebar vibration add to it.
What we measure. Sensation in each fingertip, pinch and grip strength in kilograms against the other hand, the muscle bulk at the base of the thumb, and how long you can hold the grip before the tingling starts.
This week. Hold the wheel lower and lighter, and change grip at every stop. A night splint that keeps the wrist straight is a common first step our hand therapists use. Weakness, dropping things, or thinning at the base of the thumb need a doctor. More on carpal tunnel syndrome.
Deep buttock pain from the seat
What it feels like. A deep ache in one buttock, often the right, that gets worse the longer you sit and can send tingling down the back of the thigh.
What is usually going on. A wallet in the back pocket presses on the buttock right over the sciatic nerve. The pedal leg sits slightly turned out for hours, which keeps the deep hip muscles working. Together they can irritate the nerve where it runs under those muscles.
What we measure. Hip rotation range each way, strength of the hip muscles against the other side, nerve tests, and sitting time before the pain comes on. We also check the lower back, which can send pain to the same spot.
This week. Wallet out of the back pocket, for good. Stand and walk at every break. See sciatica for how we tell the back and the buttock apart.
After a fall from the bike: wrist, collarbone and shoulder
What it feels like. A wrist that swelled after you put a hand out on the road, or a bump over the collarbone after landing on the shoulder. Many riders tape it and keep riding for a few days.
What is usually going on. A hand put out in a fall drives the force into the end of the forearm bone (distal radius fracture) or the small bone at the base of the thumb (scaphoid fracture). Landing on the point of the shoulder injures the collarbone or the AC joint. A doctor confirms what has broken and decides on a cast, a sling or surgery.
What we measure. After the doctor’s go-ahead: wrist and forearm turning range in degrees, grip in kilograms against the other hand, swelling, shoulder range and strength.
This week. Any wrist that is still painful or swollen the day after a fall needs a doctor before it needs us. Move the fingers and elbow on the injured side as your doctor allows, so they do not stiffen while the wrist or shoulder is protected.
Back to full shifts on tests, not dates
Your MC end date is when the paperwork expects you back. Your body has its own checklist. Before full shifts, we look for these:
- Sitting. Seated for the length of your longest stint between breaks without the pain building, then a full shift built up over one to two weeks.
- Lifting. A suitcase or a parcel bag of the weight you handle, lifted from the boot or the ground and carried, without symptoms that day or the next morning.
- Neck. Enough rotation each way to shoulder-check without moving your trunk.
- Hands. Grip within 10% of the other hand, and no tingling through a full grip hold on the wheel or bars.
- Riders after a fracture. Wrist weight-bearing on the handlebars, grip and forearm turning that let you brake and steer, and your doctor’s clearance.
Whether you are fit to drive or ride after a fracture, surgery or a concussion is your doctor’s decision. Pain is the first thing to leave. Strength is the last to train and recover.
Is this normal?
Usually expected: stiffness in the back and neck at the end of a long shift that eases within an hour or so of moving about, and is gone by the morning.
Worth getting checked: pain that starts earlier in each shift, pain that is still there the next morning, pain or tingling down a leg or an arm, fingers that go numb on the wheel, or any wrist or shoulder still sore a day after a fall.
When to see a doctor first
- Call 995 after a crash for anyone unconscious, with heavy bleeding, chest pain or trouble breathing, or neck pain with numbness, tingling or weakness in the arms or legs. Do not move someone with a suspected neck injury.
- Go to the emergency department now for back pain with numbness between the legs or new problems passing urine or stool, a limb that looks out of shape, a leg you cannot stand on after a fall, or a head knock followed by vomiting, confusion or a worsening headache.
- See a doctor the same day for a wrist that is painful or swollen after a fall onto the hand, pain at the base of the thumb after a fall, a bump or a step over the collarbone, or any neck pain after a collision.
- See a doctor soon for leg pain below the knee with numbness or weakness, numbness in the fingers that stays all day, weakness or dropping things, thinning of the muscle at the base of the thumb, or back pain with fever, weight loss, or night pain that does not change with position.
Questions people ask
Why does my back hurt after driving?
Hours of sitting keep the lower back in one position while the vehicle’s vibration adds a steady small load. The muscles tire and the discs stay under pressure. The pain often peaks when you stand up from the car, and lifting heavy luggage from the boot straight after a long stint is a common moment for a strain.
What our patients say
Google reviews from our clinics in Singapore.
How can I reduce back pain while driving?
Take regular breaks out of the car and walk. Set the seat so your hips sit level with or slightly above your knees, take your wallet out of your back pocket, and give your back a short pause after a long drive before lifting anything heavy from the boot. Mount the phone at eye level.
Why do my fingers go numb when I drive or ride?
Pins and needles in the thumb, index and middle fingers while driving or riding usually come from the median nerve at the wrist, in the carpal tunnel. A firm grip held for hours with the wrist bent raises the pressure in that tunnel. Weakness, dropping things or thinning at the base of the thumb need a doctor.
When should a delivery rider see a doctor after a fall?
A wrist that is painful or swollen after a fall onto the hand needs a doctor the same day, as does pain at the base of the thumb or a bump over the collarbone. A limb that looks out of shape, or a head knock followed by vomiting or confusion, needs the emergency department now.
Where are you with this right now?
1. It is settling on its own
If it eases week by week with more breaks and a better seat setup, you are on the right road. Keep the breaks once it settles. You do not need us for this, and we would rather say so.
2. It has stopped improving
It settles on your days off and comes back by the middle of the next shift. You have started taking shorter shifts, turning down the airport jobs, or getting a passenger to lift their own bag. That pattern is usually a strength and endurance problem, and rest alone rarely changes it. It is worth measuring. If it has been months, the Stalled Recovery Review runs over three weeks with the same therapist.
3. You have had surgery, or you have a date
A wrist fracture plate, a collarbone fixation, a tibial plateau fixation or a disc operation each has a shape, with protected weeks before you drive or ride. See physiotherapy after surgery, hand therapy after surgery and the recovery programs. All of it runs on the four stages of the Phoenix Recovery Protocol: Calm & Protect, Move & Mobilize, Rebuild & Strengthen, and Return & Perform.
Next step
Find out which stage you are in
Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.
Prefer to phone? Each of our five clinics has its own number on the clinics page. No referral needed to book.
Related reading
Sources
- Robb MJM, Mansfield NJ. Self-reported musculoskeletal problems amongst professional truck drivers. Ergonomics. 2007;50(6):814-827.
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