Prolonged Sitting, Cross-Legged Posture and Piriformis Syndrome in University-Aged Students: Evidence of Association from a Cross-Sectional Study

Abstract

Background: Piriformis syndrome is an under-recognized neuromuscular condition associated with sciatic nerve irritation, often linked to prolonged sitting and poor posture among young adults. Objective: To determine the prevalence of piriformis syndrome and its association with sitting duration and cross-legged posture among university students. Methods: A cross-sectional study was conducted from May to November 2024 among 198 students aged 18–26 years from multiple institutions in Swat, Pakistan. Participants were selected through random sampling. Data were collected using a structured questionnaire, the FAIR test for clinical diagnosis, and the Visual Analogue Scale for pain assessment. Ethical approval and informed consent were obtained. Data were analyzed using SPSS version 25, applying descriptive statistics and relationships between piriformis syndrome, the length of time spent sitting, and sitting posture were examined through cross-tabulations. Results: The mean age was 20.8±2.2 years, with 66.2% females. The prevalence of piriformis syndrome was 61.6% (95% CI: 54.7–68.3). Higher prevalence was observed in females (32.9%) than males (18.7%). Sitting >1 hour showed higher positivity (77.8%), while cross-legged posture was reported by 80.8% and strongly associated with symptoms. Moderate-to-severe pain (VAS 6–10) was reported by 77.7%. Conclusion: Increased Piriformis syndrome was highly prevalent and significantly associated with prolonged sitting and cross-legged posture, highlighting the need for ergonomic and preventive interventions in university settings.

Keywords: Cross-legged sitting, Ergonomics, Musculoskeletal Pain, Piriformis Muscle Syndrome, Prolonged sitting, Posture, Sedentary Behavior