Prevalence of Back and Neck Complaints in Military Rotary Wing Aircrew: A Systematic Review

Rotary-wing (helicopter) operations expose aircrew-including pilots, flight engineers, navigators, and various operators-to significant ergonomic risks, particularly affecting their lumbar and cervical spines. This strain can impair individual well-being, workforce health, and operational effectiveness.

A systematic review of five databases was performed to evaluate back and neck pain prevalence among military rotary-wing aircrew. Eligible studies included those published in English, focusing on active flying military aircrew, and providing quantitative prevalence data for back and/or neck pain. Three reviewers assessed eligibility criteria, evaluated bias using the Joanna Briggs Institute quality appraisal tool, and used Excel and SPSS analysis.

The review included 3786 rotary-wing pilots and aircrew from 28 studies. The pooled prevalence of back pain was 64%, while neck pain was reported in 52% of subjects. High statistical heterogeneity (I2) indicated variability across studies. Variations in pain definitions, aircrew roles, and aircraft types were noted. Recall of pain complaints spanned from immediately postflight to several months later. Subgroup analysis revealed no difference in pooled prevalence scores based on pain duration or intensity, contributing to the observed heterogeneity. Contributing factors included unclear injury timeframes, inconsistent definitions, and a lack of data on rear crewmembers.

Back and neck complaints among military rotary-wing aircrew impact operational capabilities. Further research is necessary to standardize pain definitions across all aircrew roles to improve understanding. Cooper N, Spratford W, Stone M, Newman P. Prevalence of back and neck complaints in military rotary wing aircrew: a systematic review. Aerosp Med Hum Perform. 2026; 97(6):451-463.