Pain in the Cervical and Lumbar Spine as a Result of High G-Force Values in Military Pilots—A Systematic Review and Meta-Analysis

Abstract

Neck pain and lower back pain are commonly reported by military pilots. That is why the answers to the following questions are important: (1) which part of the back (neck or lumbar spine) is more likely to be painful in military pilots as a result of high G-force, and (2) what intervention methods do pilots use as countermeasures for back pain resulting from high G-force? To answer these questions, the literature was searched in the following online databases: MEDLINE, PubMed, and Embase. A meta-analysis of eleven studies on pain in the neck–spine in fighter pilots vs. transport pilots showed pooled pulled OR = 1.69 (95% CI 1.25 to 2.29, I2 = 32%, p-value = 0.21); this outcome is consistent with most of the published results. A meta-analysis of five studies on pain in the lumbar spine (lower back) did not show a difference between fighter pilots vs. transport pilots with OR = 1 (95% CI 0.83 to 1.19, I2 = 0%, p-value = 0.96). The meta-analysis showed that of the two spinal segments evaluated, it was the cervical spine that showed more soreness in tactical fighter pilots. Prevention of lumbar and neck injuries should be combined with individual lumbar and neck support, as well as increasing back muscle strength through training.