Increase in Neck and Back Pain in Fighter Pilots After the Introduction of the F-35 Platform

INTRODUCTION: Fighter pilots face unique occupational challenges, including exposure to high G-forces in suboptimal seating postures and wearing heavy equipment around neck and head. these factors contribute to a high prevalence of neck and back complaints, which can impair flight performance and prevent deployment of pilots. METHODS: a cross-sectional survey was performed on the self-reported prevalence of neck and back pain among F-16 and F-35 pilots in the royal netherlands air Force. of the 121 pilots who were invited to participate, 50% (n = 61) were included. the questionnaire was based on prior research and adapted for military pilots. Differences between F-16 and F-35 pilots were analyzed. RESULTS: the subjects were 36 yr (iQr 30.0–46.0) of age and had 1900 flight hours (iQr 1000–2800). We observed a statistically significant higher prevalence of back pain among F-35 pilots compared to F-16 pilots (46% vs. 8%), whereas neck pain was higher but not statistically significant among F-35 pilots (51% vs. 38%). Contributing factors included seat angle, heavy (helmet-mounted) equipment, and specific flight maneuvers. a majority (83%) reported a negative impact on flight performance, with 38% stating it affected flight safety. Suggested preventive strategies include a multidisciplinary approach as well as adjustments of equipment. DISCUSSION: this study represents the first investigation into neck and back pain among F-35 pilots and shows a higher rate of both back and neck pain compared to F-16 pilots. Equipment and seat angle appear to be the main contributing factors. targeted interventions are needed to prevent structural injuries, improve performance, and increase deployability.