Associations Between Obesity, Piriformis Muscle Dysfunction, And Pain in Drivers: A Cross Sectional Study
Abstract
Background: Obese vehicle drivers are predisposed to piriformis syndrome due to prolonged sitting, poor posture, and increased mechanical stress. Excess body weight may intensify piriformis muscle tightness and compress the sciatic nerve, resulting in chronic pain and functional limitations.
Objective: To determine the associations between obesity, piriformis muscle dysfunction, and pain severity among professional drivers.
Methodology: This cross-sectional study was conducted over six months in District Lahore among 113 male online vehicle drivers (Uber, Careem, Foodpanda) aged 18–60 years, selected through convenient sampling. Participants with prolonged sitting time and elevated BMI were included. Data were collected using a self-designed questionnaire, the Piriformis Stretch Test, and the Visual Analog Scale (VAS) for pain assessment. Ethical approval was obtained, and informed consent was secured from all participants. Statistical analysis was performed using SPSS version 24.0, applying descriptive and Pearson’s correlation tests to evaluate relationships among BMI, Piriformis Stretch Test outcomes, and pain severity.
Results: A significant positive correlation was found between BMI and the Piriformis Stretch Test (r = 0.681, p < 0.001), indicating that drivers with higher BMI were more likely to exhibit piriformis tightness. Piriformis Stretch Test results also showed a strong correlation with pain intensity (r = 0.833, p < 0.001), while BMI correlated significantly with pain severity (r = 0.681, p < 0.001). Approximately 72% of participants reported moderate-to-severe pain (VAS > 5). Longer driving hours (>8 hours/day) and increasing age further amplified pain levels (p < 0.05).
Conclusion: Higher BMI, prolonged driving duration, and piriformis muscle dysfunction were significantly associated with increased pain severity among vehicle drivers. These findings highlight the importance of implementing targeted interventions such as weight management, ergonomic adjustments, and regular stretching programs to reduce musculoskeletal pain in this population.
Keywords: Correlation, Drivers, Obese, Occupational health, Piriformis dysfunction
References
Pande A, Gopinath RA, Ali S, Adithyan R, Pandian S, Ghosh S. Piriformis Syndrome and Variants–A Comprehensive Review on Diagnosis and Treatment. Journal of Spinal Surgery. 2021 Oct 1;8(4):7-14.
Larionov A, Yotovski P, Filgueira L. Novel anatomical findings with implications on the etiology of the piriformis syndrome. Surgical and Radiologic Anatomy. 2022 Oct;44(10):1397-407.
BUILDER V. Neurologic Pathologies and Disorders. Mosby's Pathology for Massage Professionals-E-Book: Mosby's Pathology for Massage Professionals-E-Book. 2021 Sep 5:172.
Bhattacharya S, Garg S, Grover A, Singh A. Credit carditis or fat wallet syndrome-A neglected yet, preventable public health problem. Journal of Family Medicine and Primary Care. 2024 Apr 1;13(4):1566-7.
Zenda KP. Understanding the Ergonomic Factors Associated with Lower Back Pain Amongst Mining Employees: A Case Study of Trojan Nickel Mine. University of Johannesburg (South Africa); 2023.
Iranmanesh M, Shafiei Nikou S, Saadatian A, Alimoradi M, Khalaji H, Monfaredian O, Saki F, Konrad A. The training and detraining effects of 8-week dynamic stretching of hip flexors on hip range of motion, pain, and physical performance in male professional football players with low back pain. A randomized controlled trial. Journal of Sports Sciences. 2025 Jun 6:1-5.
Muhammad A, Rana MR, Amin T, Angela C, Pereira FA, Bhutto MA. Prevalence of Piriformis Muscle Tightness among Undergraduate Medical Students. Pakistan Journal of Medical & Health Sciences. 2022 Apr 7;16(02):964-.
Salam A, Khalid A, Waseem I, Mahmood T, Mahmood W. COMPARISON BETWEEN EFFECTS OF PASSIVE VERSUS SELF-MOBILIZATION OF SCIATIC NERVE IN PIRIFORMIS SYNDROME FOR RELIEVING PAIN AND IMPROVING HIP OUTCOMES: soi: 21-2017/re-trjvol06iss01p298. The Rehabilitation Journal. 2022 Mar 31;6(01):298-302.
Hill L, Brandon K. Musculoskeletal Assessment for Patients with Pelvic Pain. Management of Chronic Pelvic Pain: A Practical Manual. 2021 Mar 25:33.
Linck G, Boissonnault B. Symptom Investigation: Screening for Medical Conditions. InFoundations of Orthopedic Physical Therapy 2024 Jun 1 (pp. 80-104). Routledge.
Sharif S, Ali MY, Kirazlı Y, Vlok I, Zygourakis C, Zileli M. Acute back pain: The role of medication, physical medicine and rehabilitation: WFNS spine committee recommendations. World Neurosurgery: X. 2024 Mar 6:100273.
Serdar CC, Cihan M, Yücel D, Serdar MA. Sample size, power and effect size revisited: simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochemia medica. 2021 Feb 15;31(1):27-53.
Girard L, Djemili F, Devineau M, Gonzalez C, Puech B, Valance D, Renou A, Dubois G, Braunberger E, Allou N, Allyn J. Effect of body mass index on the clinical outcomes of adult patients treated with venoarterial ECMO for cardiogenic shock. Journal of Cardiothoracic and Vascular Anesthesia. 2022 Aug 1;36(8):2376-84.
Othman IK, Raj NB, Siew Kuan C, Sidek S, Wong LS, Djearamane S, Loganathan A, Selvaraj S. Association of piriformis thickness, hip muscle strength, and low back pain patients with and without piriformis syndrome in Malaysia. Life. 2023 May 18;13(5):1208.
Choudhari A, Gupta AK, Kumar A, Kumar A, Gupta A, Chowdhury N, Kumar A. Wear and friction mechanism study in knee and hip rehabilitation: A comprehensive review. Applications of biotribology in biomedical systems. 2024 Jun 30:345-432.
Adouni M, Aydelik H, Faisal TR, Hajji R. The effect of body weight on the knee joint biomechanics based on subject-specific finite element-musculoskeletal approach. Scientific Reports. 2024 Jun 14;14(1):13777.
Tahran Ö, Ersoz Huseyinsinoglu B, Yolcu GÜ, Karadağ Saygı E, Yeldan İ. Comparing face-to-face and internet-based basic body awareness therapy for fibromyalgia: a randomized controlled trial. Disability and Rehabilitation. 2025 Feb 19:1-2.
Bonaldi L, Berardo A, Stecco A, Stecco C, Fontanella CG. Assessment of the Fascial System Thickness in Patients with and Without Low Back Pain: A Narrative Review. Diagnostics. 2025 Aug 16;15(16):2059.
Faryad I, Khalid F, Munawar A, Iqbal MH, Anwar A. Prevalence of Piriformis Syndrome among Tailoring Professionals and its Association with Prolong Sitting. Journal of Health, Wellness and Community Research. 2025 Jul 14: e482-.
Aroob Z, Bashir MS, Noor R, Ikram M, Ramzan F, Naseer A, Sabir N. Comparative effects of fascial distortion model with and without neuromuscular inhibition technique on pain, range of motion and quality of life in patients with piriformis syndrome. Disability and Rehabilitation. 2025 Apr 24;47(9):2378-83.
Powell J, Kent T, Hanson C. Dysfunction, Evaluation, Diagnosis, and Treatment of the Hip Complex: Nonsurgical and Surgical. Foundations of Orthopedic Physical Therapy. 2024 Jun 1:211-36.
Prentice WE. Understanding and managing the healing process through rehabilitation. InRehabilitation Techniques for Sports Medicine and Athletic Training 2024 Jun 1 (pp. 23-56). Routledge.
Cárdenas-Sandoval RP, Pastrana-Rendón HF, Avila A, Ramírez-Martínez AM, Navarrete-Jimenez ML, Ondo-Mendez AO, Garzón-Alvarado DA. Effect of therapeutic ultrasound on the mechanical and biological properties of fibroblasts. Regenerative Engineering and Translational Medicine. 2023 Jun;9(2):263-78.
Spencer L. Investigation of the Metabolic Effects of Liraglutide on Patients with Overweight and Obesity. University of Derby (United Kingdom); 2023.
Adouni M, Aydelik H, Faisal TR, Hajji R. The effect of body weight on the knee joint biomechanics based on subject-specific finite element-musculoskeletal approach. Scientific Reports. 2024 Jun 14;14(1):13777.
Benzon HT, Katz JA, Benzon HA, Iqbal MS. Piriformis syndrome: Anatomic considerations, diagnosis, and treatment. Anesthesiology Clinics. 2013;31(2):247-260.
Othman IK, Raj NB, Siew Kuan C, Sidek S, Wong LS, Djearamane S, Loganathan A, Selvaraj S. Association of piriformis thickness, hip muscle strength, and low back pain patients with and without piriformis syndrome in Malaysia. Life. 2023 May 18;13(5):1208.
Beals JW, Kayser BD, Smith GI, Schweitzer GG, Kirbach K, Kearney ML, Yoshino J, Rahman G, Knight R, Patterson BW, Klein S. Dietary weight loss-induced improvements in metabolic function are enhanced by exercise in people with obesity and prediabetes. Nature metabolism. 2023 Jul;5(7):1221-35.
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