By Sana Fatemi
For many truck drivers, pain comes with the territory. Long hours behind the wheel, tight delivery windows, and limited opportunities to move mean aches and stiffness are often brushed off as part of the job. Lower back pain, in particular, is widespread among commercial drivers, with occupational health studies consistently identifying prolonged sitting as a significant risk factor for musculoskeletal injury. (Canadian Centre for Occupational Health and Safety).
But for many truckers, ongoing lower back, hip, or leg pain may not stem from the spine at all. Instead, it could be caused by a lesser-known condition called piriformis syndrome, a treatable but often overlooked source of nerve pain that can gradually worsen over time.
Often mistaken for sciatica, piriformis syndrome is increasingly recognized by clinicians as a potential issue among workers who sit for extended periods, according to the Cleveland Clinic. For truck drivers, the combination of prolonged sitting, repetitive movement, and physical labour creates a perfect storm.
What Is Piriformis Syndrome?
The piriformis is a small muscle situated deep in the buttocks, extending from the sacrum at the base of the spine to the top of the femur. Its main function is to stabilize the hip and aid with leg rotation, particularly during walking and shifting movements. (Mayo Clinic)
The sciatic nerve, the largest nerve in the body, passes very close to the piriformis muscle. In some individuals, it runs directly beneath it. When the piriformis becomes tight, inflamed, or overused, it can compress or irritate the sciatic nerve, resulting in pain that closely resembles traditional sciatica, according to the Mayo Clinic and the Cleveland Clinic.
According to a review published in the Journal of the American Academy of Orthopaedic Surgeons, because the symptoms of Piriformis often mimic those caused by disc problems in the lower spine, they are frequently misdiagnosed or dismissed, particularly in workers who expect back pain as part of their occupation.
Why Truckers Are at Higher Risk
Truck driving imposes sustained and specific demands on the body, particularly the hips, lower back, and legs. Several risk factors make drivers especially susceptible to piriformis syndrome.
Prolonged sitting, often for eight to twelve hours a day, keeps the hips in a flexed position, which can shorten and tighten deep hip muscles over time, according to the Canadian Centre for Occupational Health and Safety. Limited hip movement, combined with poorly adjusted seats or inadequate lumbar support, further increases strain on the pelvis and surrounding muscles.
Drivers also perform physically demanding tasks, such as lifting tarps, chains, and cargo. Repetitive actions like climbing in and out of the cab, often favouring one side of the body, can cause muscle imbalance, physiotherapists observe.
Postural habits also influence discomfort. Sitting on a thick wallet in a back pocket, sometimes referred to as “wallet sciatica,” can tilt the pelvis and increase pressure on the sciatic nerve, according to Harvard Health Publishing.
Whole-body vibration from the truck itself introduces an additional risk. Studies published in Occupational and Environmental Medicine have linked long-term exposure to vehicle vibration with higher rates of lower back and soft-tissue injuries among professional drivers.
How Piriformis Syndrome Affects Life on the Road
Piriformis syndrome not only causes discomfort but can also hinder a driver’s ability to work safely and efficiently.
Drivers with untreated symptoms may struggle to sit comfortably for extended periods, leading to frequent position changes, increased fatigue, and reduced focus. Pain can flare when getting out of the cab after a long haul, making routine movements even more difficult. Sleep is often affected as well. Pain in the hip or leg can persist in the sleeper berth, leading to poor rest and slower recovery between shifts. Factors that Transport Canada has associated with increased crash risk.
Over time, the condition can interfere with basic job tasks such as backing up, checking blind spots, climbing stairs, changing tires, or maintaining balance on uneven ground. Some drivers reduce mileage or miss work entirely due to pain, affecting income and long-term job sustainability.
Left untreated, piriformis syndrome can become chronic, leading to ongoing nerve irritation and increased sensitivity.
Warning Signs Truckers Often Ignore
Many drivers assume the pain is “just lower back pain” or a flare-up of sciatica, a misconception clinicians say is common among workers who sit for long hours, including truck drivers, according to the Cleveland Clinic. Others notice discomfort worsening during long drives but easing slightly after time off, reinforcing the belief that it’s temporary, a pattern frequently noted in musculoskeletal research.
Common warning signs include:
- Pain that worsens the longer you sit
- Needing to shift positions frequently while driving
- Pain after loading, unloading, or climbing out of the cab
- Tingling or numbness down one leg
- Weakness or discomfort when pressing pedals
When these symptoms become frequent or progressively worse, they should not be ignored, healthcare professionals warn.
Diagnosis: How to Know If It’s Piriformis Syndrome
Proper diagnosis is essential, as treatment differs from that of spinal disc injuries, according to Mayo Clinic.
Healthcare providers usually start by ruling out lumbar disc problems or spinal nerve compression. Physical exams may include specific tests like the FAIR test (flexion, adduction, internal rotation), the Pace test, or direct palpation of the piriformis muscle to reproduce symptoms, according to the Cleveland Clinic.
Imaging such as MRI may be used in some cases, primarily to exclude other causes rather than to confirm piriformis syndrome itself, clinicians say, as noted by the Journal of the American Academy of Orthopaedic Surgeons.
Preventing Piriformis Syndrome for Truckers
Prevention focuses on reducing prolonged strain and improving mobility, even in small ways.
In the Cab:
- Adjust seat height so hips sit slightly higher than knees
- Ensure proper lumbar support
- Avoid sitting on wallets or bulky items
- Consider an ergonomic or memory-foam seat cushion
Ergonomics specialists note that proper seat positioning can significantly reduce strain on the hips and lower back during long-haul driving.
On the Road:
- Take short movement breaks every one to two hours
- Walk around the truck during stops
- Perform simple stretches such as hip flexor, hamstring, and figure-4 stretches
Even brief movement breaks can significantly reduce muscle tightness, according to guidance from physiotherapy and occupational health organizations.
Lifestyle Habits:
- Strengthen the glutes and hip stabilizers
- Maintain hydration to support muscle health
- Use heat packs while parked to relax tight muscles, or alternate heat and cold if inflammation is present
Healthcare providers say consistent strengthening and mobility routines play a key role in preventing recurring nerve compression.
Treatment Options
When piriformis syndrome does occur, treatment is often effective, clinicians say.
Physical therapy is the most common approach, focusing on stretching, strengthening, and reducing muscle tension. Trigger-point therapy, massage, and foam rolling are frequently used according to physiotherapy treatment guidelines.
Anti-inflammatory medications may help in the short term if prescribed. Some drivers also benefit from chiropractic or osteopathic care, particularly when pelvic alignment contributes to symptoms, musculoskeletal specialists note.
In more severe cases, corticosteroid or Botox injections may be considered to reduce muscle spasm and nerve compression. Surgical intervention is rare and typically reserved for cases that do not respond to conservative treatment, according to guidance from the Mayo Clinic and the Cleveland Clinic.
Conclusion
Piriformis syndrome is a common but frequently overlooked condition in the trucking industry. The good news is that it is highly treatable and often preventable.
Recognizing symptoms early and making small adjustments to posture, mobility, and cab ergonomics can prevent long-term pain and missed work. For drivers whose livelihoods depend on remaining behind the wheel, addressing hip and nerve pain promptly is not just about comfort, it’s about career longevity.
Sometimes, the smallest adjustments make the biggest difference.