I drive a stick shift (most of the time.) I am lucky in that my right side is unaffected, so I can shift, operate the parking brake, etc. Other than that, I try my best (read: I forget until it hurts sometimes) to keep my left hand on the bottom of the steering wheel. The only times that this is a MAJOR problem is when I'm shifting going into or out of a turn, so I'm turning the wheel w/ my left hand . I tried driving an automatic from ~ oct thru feb and I didn't notice a major difference in my pain levels on a regular basis. That being said, if I had another car, and it was an automatic, I would drive that every day. If I had to shift with my right hand- forget it, i don't think i would be able to.