Introduction:​ Today’s demands on helicopter missions—often using helmet-mounted visual technology—place much physical stress on the cervical spine. The objective of the present analytical survey was to estimate the prevalence of, and associated risk factors for, helicopter pilots’ neck pain and related disability.

Methods:​ There were 127 Swedish helicopter pilots consecutively enrolled for the study who completed a structured questionnaire during their regular medical health checkups. The questionnaire concerned flight-related and individual risk indicators, frequency of neck pain episodes, and disability. Multivariate regressions, with the potential to control for confounding factors, were used to estimate relative risks (RR).

Results:​ The 3-mo prevalence of neck pain was 57%, with 32% reporting frequent pain. A history of previous neck pain (RR = 1.8, 95% CI = 1.2–2.7) and recent shoulder pain (RR = 1.6, 95% CI = 1.1–2.4) were significant risk factors, while the use of night-vision goggles and muscle strength-training showed a non-significant associated trend, the latter toward a decreased risk. In neck pain cases, 58% and 55% reported that their pain interfered with their flying and leisure, respectively, and those with frequent pain risked pain interfering with flying duty (RR = 1.6, 95% CI = 1.1–2.5). However, only 25% of the cases had ever been on sick leave due to neck pain.

Conclusions:​ Neck pain is common among helicopter pilots, and certain factors are identified for use in risk reduction. The link between cases with frequent pain and reported interference with flying duty highlights the need for early prevention of neck pain when planning and implementing helicopter pilots’ health care. More clinical trials of good design are required.