Low back pain in the AH-1 Cobra helicopter.

Pilots of the AH-1S helicopter maintain a vertical sitting position in the gunner's position (front seat), whereas in the pilot's seat (rear), they lean forward and to the left in order to operate the controls. A cross over study with pilots flying alternately in the front and rear positions was used to assess the effect of crew position on the prevalence of low back pain during flight. In the pilot's seat, there was an increased prevalence of pain (72.2%, 13/18 versus 55.6%, 10/18); the onset of pain was quicker than experienced in the gunner's position (64.3%, 9/14 versus 7.1%, 1/14, p less than 0.001); and the intensity was greater (85.7%, 12/14 versus 7.1%, 1/14, p less than 0.001). We conclude that posture is an important component of the low back pain experienced by helicopter pilots during flight.