Manual Therapy for Chronic Low Back Pain in an F-5 Pilot

Mil Med. 2015 Oct;180(10):e1132-5. doi: 10.7205/MILMED-D-14-00712.


Introduction: Low back pain (LBP) in the aviator can be a significant safety risk because of distraction during flight. Flight Surgeons are tasked with seeking out appropriate medical care that reduces pilot risk while providing squadron-specific mission support.

Case: An F-5 pilot presented with chronic LBP seeking nonpharmacological and noninvasive therapy. After 3 days of manual treatment that corrected sacral, pelvic, and lumbar dysfunction, this pilot reported greater than 80% reduction in overall pain and was able to return to flight.

Discussion: Although underreported, a radiographic study and multiple case reports, identify LBP as a significant problem among tactical air (tac air) pilots. As such, LBP can become an in-flight distraction increasing the risk of a mishap. Benefits of osteopathic manipulative therapy (OMT) as an adjunct to treatment of LBP in civilian population were recently demonstrated. This case identified a tac air pilot with chronic LBP that responded to three OMT sessions focused at the sacrum, lumbar, and pelvis.

Conclusion: The use of manual therapy in the form of OMT significantly reduced this pilot's pain in three visits and maintained flight status per aeromedical waiver guidelines.

Publication types

  • Case Reports

MeSH terms

  • Chronic Pain / diagnosis
  • Chronic Pain / therapy*
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / therapy*
  • Male
  • Middle Aged
  • Military Personnel*
  • Musculoskeletal Manipulations / methods*
  • Pain Measurement
  • Pilots*
  • Severity of Illness Index