title: Manual Therapy for Chronic Low Back Pain in an F-5 Pilot.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Naval Strike and Air Warfare Center, 4755 Pasture Road, Fallon, NV 89406-5000.
authors.forename: Chad T
authors.initials: CT
authors.lastname: Andicochea
authors.affiliation: Naval Strike and Air Warfare Center, 4755 Pasture Road, Fallon, NV 89406-5000.
authors.forename: Joel
authors.initials: J
authors.lastname: Fulkerson
authors.affiliation: Walter Reed National Medical Center, 8901 Rockville Park, Bethesda, MD 20889.
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Taylor
authors.affiliation: Department of Emergency Medicine, Naval Medical Center, 34800 Bob Wilson Door, San Diego, CA 92134.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Portouw
mesh_terms: D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010147:Pain Measurement; D000070356:Pilots; D012720:Severity of Illness Index