title: Neck pain among fighter pilots after the introduction of the JHMCS helmet and NVG in their environment.
abstract: BACKGROUND
  Neck pain is a common complaint among fighter pilots. With implementation of the joint helmet mounted cuing system (JHMCS), the strain on the pilot's neck has increased.
  
  
  METHODS
  We surveyed 58 F-16 pilots from the Royal Danish Air Force by anonymous questionnaires. More than half of these pilots used JHMCS regularly.
  
  
  RESULTS
  The response rate was 100%. Of the pilots, 97% experienced neck pain in flight or shortly after flying, 83% within the last year. Right side neck pain was significantly more frequent than left side, odds ratio 3.25. There was a strong tendency toward predominant right-sided shoulder pain. The pilots reported that combined rotation and extension movements were especially hazardous. Only 1 in 10 pilots moved his head independent of G-load. Neck pain influenced operational flying, especially the ability to perform a "check six" movement sufficiently, and affected flying with high G loads as occurs in basic fighter maneuvers and air combat maneuvering.
  
  
  CONCLUSIONS
  To avoid neck problems the majority of pilots aim to avoid certain head movements and to fix their neck before exposing themselves to high +Gz loads. With the implementation of JHMCS, two conflicting goals are evident and working at cross-purposes. A pilot's head should remain stationary while exposed to high +Gz loads. However, maximizing the advantages of JHMCS encourages the pilot to move his head sharply while exposed to high +Gz loads. Training programs to help the pilots cope with these challenges are warranted.
authors: Air Tactical Command, Karup, Denmark. brittlange@dadlnet.dk
authors: Britt
authors: B
authors: Lange
authors: Jørgen
authors: J
authors: Torp-Svendsen
authors: Palle
authors: P
authors: Toft