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

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

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Naval Strike and Air Warfare Center, 4755 Pasture Road, Fallon, NV 89406-5000.
Walter Reed National Medical Center, 8901 Rockville Park, Bethesda, MD 20889.
Department of Emergency Medicine, Naval Medical Center, 34800 Bob Wilson Door, San Diego, CA 92134.



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.


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.


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.


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.

[Indexed for MEDLINE]

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