Comparison of Neck Pain and Disability With and Without Helmet in Commercial Bikers

Background: Neck pain is a common musculoskeletal complaint among commercial bike riders because of prolonged riding duration, sustained cervical posture, repetitive road vibration, occupational workload, and possible helmet-related biomechanical loading. Although helmets are essential for head-injury prevention, their relationship with neck pain and neck-related disability remains clinically debated. Objective: To compare the prevalence and severity of neck pain and neck-related disability among commercial bike riders with and without helmet use. Methods: This observational cross-sectional study was conducted among 231 male commercial bike riders in Lahore, Pakistan. Participants were selected through non-probability convenience sampling and categorized into helmet users (n = 115) and non-helmet users (n = 116). Data were collected using a self-structured questionnaire, Numeric Pain Rating Scale, and Neck Disability Index. Descriptive statistics and chi-square tests were applied using IBM SPSS Statistics version 25, with p < 0.05 considered statistically significant. Results: Neck pain was reported by 67 helmet users (58.3%) and 85 non-helmet users (73.3%). Non-helmet users had higher crude odds of neck pain than helmet users (OR = 1.96; 95% CI: 1.13–3.42; p = 0.016). Severe-to-complete disability was more frequent among non-helmet users than helmet users (15.5% vs 6.1%), whereas moderate disability was higher among helmet users (24.3% vs 16.4%). Neck pain was significantly associated with Neck Disability Index category within both helmet users and non-helmet users (p < 0.001). Conclusion: Neck pain and disability were common among commercial bike riders, with greater neck-pain prevalence and severe-disability burden among non-helmet users. These findings suggest that cervical symptoms in commercial riders are multifactorial and should be addressed through helmet safety, ergonomic correction, posture education, and preventive neck-care strategies.