Musculoskeletal pain in military helicopter and airplane pilots of the Paraguayan Air Force
DOI:
https://doi.org/10.5281/zenodo.22817303Keywords:
musculoskeletal pain, military pilots, aviation, aerospace medicine, occupational healthAbstract
Introduction: Military pilots are exposed to prolonged and asymmetric postures, whole-body vibration, acceleration forces and head-borne equipment that favor musculoskeletal pain, documented in air forces of various countries but not previously studied in Paraguay. The aim was to determine the prevalence, characteristics and associated factors of this pain in military helicopter and airplane pilots of the Paraguayan Air Force during 2025.
Materials and methods: Descriptive, non-experimental, cross-sectional quantitative study in a census sample of 46 active pilots. A sociodemographic questionnaire, the Nordic musculoskeletal symptoms questionnaire and the Neck Disability Index and Oswestry Disability Index were applied.
Results: The lumbar and cervical regions were the most affected (52% and 43%). Helicopter pilots had the highest pain prevalence, particularly lumbar, attributed mainly to vibration; combat pilots related symptoms to G-forces and transport pilots to sustained posture. Most had received no treatment in the previous 12 months. Functional impact was low: 75% without cervical disability and 42% without lumbar disability.
Conclusions: Musculoskeletal pain is frequent among FAP pilots and its patterns are consistent with the biomechanical demands of each aircraft, supporting differentiated preventive and physiotherapeutic strategies by operational profile.
References
Posch M, Schranz A, Lener M, Senn W, Äng BO, Burtscher M, et al. Prevalence and potential risk factors of flight-related neck, shoulder and low back pain among helicopter pilots and crewmembers: a questionnaire-based study. BMC Musculoskelet Disord. 2019;20(1):44. https://doi.org/10.1186/s12891-019-2421-7
Tegern M, Aasa U, Larsson H. Cervico-thoracic pain and associated impairments in air force personnel: a cross-sectional study. BMC Musculoskelet Disord. 2021;22(1):441. https://doi.org/10.1186/s12891-021-04301-w
Tegern M, Aasa U, Äng BO, Larsson H. Musculoskeletal disorders and their associations with health- and work-related factors: a cross-sectional comparison between Swedish air force personnel and army soldiers. BMC Musculoskelet Disord. 2020;21(1):303. https://doi.org/10.1186/s12891-020-03251-z
Wagstaff AS, Jahr KI, Rodskier S. +Gz-induced spinal symptoms in fighter pilots: operational and individual associated factors. Aviat Space Environ Med. 2012;83(11):1092-6. https://doi.org/10.3357/asem.3146.2012
Mastalerz A, Maruszyńska I, Kowalczuk K, Garbacz A, Maculewicz E. Pain in the cervical and lumbar spine as a result of high G-force values in military pilots: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022;19(20):13413. https://doi.org/10.3390/ijerph192013413
Mo F, Meng Q, Wu K, Zhang Q, Li K, Liao Z, et al. A neuromuscular human body model for lumbar injury risk analysis in a vibration loading environment. Comput Methods Programs Biomed. 2023;235:107442. https://doi.org/10.1016/j.cmpb.2023.107442
Pousette MW, Lo Martire R, Linder J, Kristoffersson M, Äng BO. Neck muscle strain in air force pilots wearing night vision goggles. Aerosp Med Hum Perform. 2016;87(11):928-32. https://doi.org/10.3357/AMHP.4579.2016
Heggli U, Swanenburg J, Hofstetter L, Häusler M, Schweinhardt P, Bron D. Typical cockpit ergonomics influence on cervical motor control in healthy young male adults. Aerosp Med Hum Perform. 2023;94(3):107-12. https://doi.org/10.3357/AMHP.6096.2023
Yang F, Wang Z, Zhang H, Xie B, Zhao H, Gan L, et al. Prevalence and risk factors of occupational neck pain in Chinese male fighter pilots: a cross-sectional study based on questionnaire and cervical sagittal alignment. Front Public Health. 2023;11:1226930. https://doi.org/10.3389/fpubh.2023.1226930
Al Rumaithi M, Al Qubaisi M, Al Suwaidi M, Al Zaabi F, Campos LA, Baltatu OC, et al. Determinants of cervical spine disorders in military pilots: a systematic review. Occup Med (Lond). 2023;73(5):236-42. https://doi.org/10.1093/occmed/kqad067
Wallace JB, Newman PM, McGarvey A, Osmotherly PG, Spratford W, Gabbett TJ. Factors associated with neck pain in fighter aircrew: a systematic review and meta-analysis. Occup Environ Med. 2021;78(12):900-12. https://doi.org/10.1136/oemed-2020-107103
Yang Y, Liu S, Ling M, Ye C. Prevalence and potential risk factors for occupational low back pain among male military pilots: a study based on questionnaire and physical function assessment. Front Public Health. 2021;9:744601. https://doi.org/10.3389/fpubh.2021.744601
Correia Bulhões LC, Alves Gomes SR, da Silva VD, de Azevedo Rodolfo JI, Macedo LB, Brasileiro JS. Effects of a mat Pilates-based exercise program for low back pain in helicopter pilots of the Brazilian Air Force: randomized controlled trial. J Bodyw Mov Ther. 2024;39:544-9. https://doi.org/10.1016/j.jbmt.2024.03.052
Andersen K, Baardsen R, Dalen I, Larsen JP. Impact of exercise programs among helicopter pilots with transient low back pain. BMC Musculoskelet Disord. 2017;18(1):269. https://doi.org/10.1186/s12891-017-1631-0
Heng W, Wei F, Liu Z, Yan X, Zhu K, Yang F, et al. Physical exercise improved muscle strength and pain on neck and shoulder in military pilots. Front Physiol. 2022;13:973304. https://doi.org/10.3389/fphys.2022.973304
Fernández-Morales C, Albornoz-Cabello M, Cardero-Durán MLÁ, Moreno-Vázquez JM, Espejo-Antúnez L. Effectiveness of a multimodal physiotherapy program in fighter pilots with flight-related neck pain: a randomized controlled trial. PM R. 2025. https://doi.org/10.1002/pmrj.13399
Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233-7. https://doi.org/10.1016/0003-6870(87)90010-x
Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991;14(7):409-15. https://pubmed.ncbi.nlm.nih.gov/1834753/
Fairbank JC, Couper J, Davies JB, O'Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-3. https://pubmed.ncbi.nlm.nih.gov/6450426/
Gomes SRA, Mendes PRF, Costa LDO, Bulhões LCC, Borges DT, Macedo LB, et al. Factors associated with low back pain in air force fighter pilots: a cross-sectional study. BMJ Mil Health. 2022;168(4):299-302. https://doi.org/10.1136/bmjmilitary-2021-001851
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Eva Jazmín Villalba Medina, María José Salinas Miranda (Autor/a)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles are distributed under the Creative Commons Attribution 4.0 International — CC BY 4.0 licence. Authors retain copyright and grant the journal the right of first publication. Any reuse must acknowledge authorship, cite the original source and indicate whether changes were made.
