Risk Factors for Cervical Pain in F-15C Pilots

INTRODUCTION: Many fighter pilots report cervical pain during their careers. Etiology likely relates to +G(Z) exposure, physical positioning with maneuvers, and varying load associated with headgear. We evaluated whether selected risk factors predicted cervical pain in this population.& para;& para;METHODS: An Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant, controlled crossover study of the use of home cervical traction was undertaken with 20 male F-15C pilots. We recorded pilotage (mean 38 yr, range 34-49), total high-G hours (2338 h, range 1038-4645), and previous neck problems and measured cervical range of motion. For 12 wk, pilots logged pre- and postflight pain, whether the Joint Helmet Mounted Cueing System (JHMCS) was employed, maximum +G(Z) experienced, and sortie duration. Pain with and without JHMCS was compared using paired t-tests and correlations assessed with Pearson or Spearman coefficients.& para;& para;RESULTS: Mean flight-related pain increased by 0.73 on the numerical rating scale with JHMCS and 0.52 without. Neck extension coupled with JHMCS use correlated negatively with increased pain (r = - 0.551). Higher numbers of previously reported neck problems correlated with pain when using JHMCS (r = 0.629). Age, maximum +G(Z) per sortie, total high-G(z )hours flown, and hours per sortie did not correlate.& para;& para;DISCUSSION: To our knowledge, this is the first prospective evaluation of risk factors for fighter pilots' cervical pain. Neck pain was significantly worse with JHMCS use and with flexed posture or history of prior neck problems combined with JHMCS use.This information will help guide countermeasure development for hlgh-G pilots.