Conservative management of uncomplicated mechanical neck pain in a military aviator

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Conservative management of uncomplicated mechanical neck pain in a military aviator


Bart N. Green, DC, MSEd
Andrew S. Dunn, DC, MEd, MS
LCDR Solomon M. Pearce, D
Claire D. Johnson, DC, MSEd


Fighter jet aviators are exposed to large tensile, axial compression, and shear forces when flying, especially during aerial combat maneuvers (ACM).1 Non-radicular neck pain arising from mechanical structures in the neck (somatic
pain) is a common outcome of exposure to high gravitational (G) forces.2 The weight of the helmet and oxygen mask and the various non-neutral head postures assumed
when observing for enemy aircraft contribute to this problem. 1 Spinal disorders can result in disability3 and conditions that may disqualify pilots from flight duties.4 Thus, neck pain in the fi ghter jet aviator population has a negative impact on work performance, productivity, and is a threat to combat readiness.5 In addition to non-steroidal anti-infl ammatory drugs (NSAIDs) and short courses of analgesics, the US Navy Aeromedical Reference and Waiver Guide and the US Air Force Waiver Guide recommend mobilization exercises and manipulative therapy
in the management of mechanical non-radicular spine pain.6,7 Despite recommendations by these guides and the high prevalence of neck pain,8 we could fi nd no published
studies that describe the use of manual therapy, spinal manipulation, or spinal mobilization and therapeutic exercise for managing mechanical neck pain in aviators. In this article we present the case of a jet fighter aviator with uncomplicated mechanical neck pain who had a favorable response to conservative interdisciplinary management using manual therapy and therapeutic exercise