Helicopter Pilots and Low Back Pain: How to Manage the Risk Factors?

A high prevalence of LBP in helicopter pilots has been reported by several epidemiological surveys since the early 1960's. As pointed out by several authors the most important etiologic factor of LBP in helicopter pilots is the asymmetrical posture adopt during flight. The aim of the study is understand the pathomechanical model of the low back pain (LBP) that affects helicopter pilots in order to propose a risk management addressed to reduce this issue. A comprehensive literature review was performed to identify evidences about low back pain in helicopter pilots, risk factors related and some interventions/risk management adopted. In addition, a self-reported questionnaire was applied for LBP prevalence and pain characterization. Results showed asymmetrical in-flight posture; cockpit design/geometry; seat design; WBV; static posture; prolonged sitting; and flight duration as mainly risk factors and a higher prevalence of LBP among helicopter pilots as well as a significant influence of flight activity on pain features when compared to office workers. In order to solve the problem it will be necessary to provide a comprehensive solution composed by three different and complementary steps: a specific exercise program (as an immediate solution), the use of lumbar support (as a short term solution), and a proposal for redesign cockpit and seat (as a long term solution).