{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T04:08:12Z","timestamp":1745899692386,"version":"3.40.4"},"reference-count":24,"publisher":"Aerospace Medical Association","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p><jats:bold>INTRODUCTION:<\/jats:bold> Neck pain during military flight is well documented. Characterizing operationally relevant, specific pain location(s), severity, character, and exacerbating or relieving conditions is needed to develop musculoskeletal neck pain prediction models.<\/jats:p>\n<jats:p><jats:bold>METHODS:<\/jats:bold> An anonymous, web-based questionnaire and weighted numerical response index was developed with the help of an expert clinical panel. The questionnaire was reviewed, approved, and disseminated to military pilots. Respondents reported their current neck and upper back musculogenic and neurogenic pain with a 5-level severity at 14 locations, pain onset time, duration, and relief measures, and three-axis neck mobility.<\/jats:p>\n<jats:p><jats:bold>RESULTS:<\/jats:bold> Of 222 fixed and rotary wing pilot respondents, 117 completed questionnaires were used for index calculation. Bilateral moderate musculogenic and neurogenic pain in the 10 posterior muscle areas was most common. Flexor muscles were infrequently indicated. Typically, neck pain started within 30 min of flight or pilots were already in pain, pain duration was less than 7 d, and pain was relieved by rest with over-the-counter medications or by a chiropractor or physical therapist. Neck motion limitations were equally rated as very limited, slight, or no restriction. The normalized index was divided into five ranges where 78% were very mild to mild severity.<\/jats:p>\n<jats:p><jats:bold>DISCUSSION:<\/jats:bold> This new approach differentiates between musculogenic and neurogenic pain by discrete location and severity, addressing pain pattern, structural involvement, and neck mobility changes beyond pain absence or presence. This information can help define necessary model complexity to simulate neck pain biomechanics. The index has potential medical use in tracking pain progression and treatment progress.<\/jats:p>\n<jats:p><jats:bold>Whitley PE, Shender BS, Shivers BL. <jats:italic>Initial evaluation of the Operational Neck Pain Index<\/jats:italic>. Aerosp Med Hum Perform. 2025; 96(5):367\u2013377.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6549.2025","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:01:01Z","timestamp":1745884861000},"page":"367-377","source":"Crossref","is-referenced-by-count":0,"title":["Initial Evaluation of the Operational Neck Pain Index"],"prefix":"10.3357","volume":"96","author":[{"given":"Phillip E.","family":"Whitley","sequence":"first","affiliation":[{"name":"From CFD Research Corporation, Huntsville, AL, United States; and the Naval Air Warfare Center Aircraft Division, Patuxent River, MD, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry S.","family":"Shender","sequence":"additional","affiliation":[{"name":"From CFD Research Corporation, Huntsville, AL, United States; and the Naval Air Warfare Center Aircraft Division, Patuxent River, MD, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany L.","family":"Shivers","sequence":"additional","affiliation":[{"name":"From CFD Research Corporation, Huntsville, AL, United States; and the Naval Air Warfare Center Aircraft Division, Patuxent River, MD, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1911","reference":[{"key":"B1","article-title":"Aircrew neck pain prevention and management","author":"Farrell PSE","year":"2019","unstructured":"Farrell PSE, Shender BS, Goff CP, Boudou J, Crowley J,  Aircrew neck pain prevention and management. Research and Technology Organization (NATO); 2019. [Accessed March 18, 2025]. Available from https:\/\/apps.dtic.mil\/sti\/trecms\/pdf\/AD1183657.pdf."},{"issue":"3","key":"B2","series-title":"Aerosp Med Hum Perform.","first-page":"192","article-title":"The descriptive epidemiology of neck pain in DoD aviators","volume":"86","author":"Rizo EB","year":"2015","unstructured":"Rizo EB, Rice GM. The descriptive epidemiology of neck pain in DoD aviators. [Abstract No. 111]. Aerosp Med Hum Perform. 2015; 86(3):192."},{"issue":"1","key":"B3","series-title":"BMC Musculoskelet Disord.","article-title":"Prevalence and potential risk factors of flight-related neck, shoulder and low back pain among helicopter pilots and crewmembers: a questionnaire-based study","volume":"20","author":"Posch M","year":"2019","unstructured":"Posch M, Schranz A, Lener M, Senn W, \u00c4ng BO,  Prevalence and potential risk factors of flight-related neck, shoulder and low back pain among helicopter pilots and crewmembers: a questionnaire-based study. BMC Musculoskelet Disord. 2019; 20(1)."},{"key":"B4","series-title":"Muscle pain: understanding the mechanisms.","year":"2010","unstructured":"Mense S, Gerwin RD, eds. Muscle pain: understanding the mechanisms. Berlin (Germany): Springer; 2010. 10.1007\/978-3-540-85021-2"},{"issue":"3","key":"B5","series-title":"Br Med Bull.","first-page":"644","article-title":"Neurogenic pain syndromes and their management","volume":"47","author":"Bowsher D.","year":"1991","unstructured":"Bowsher D. Neurogenic pain syndromes and their management. Br Med Bull. 1991; 47(3):644\u2013666."},{"issue":"12","key":"B6","series-title":"J Dent Educ.","first-page":"1378","article-title":"Pain and the neuromatrix in the brain","volume":"65","author":"Melzack R.","year":"2001","unstructured":"Melzack R. Pain and the neuromatrix in the brain. J Dent Educ. 2001; 65(12):1378\u20131382."},{"issue":"4","key":"B7","series-title":"J Clin Nurs.","first-page":"650","article-title":"Pain: clinical manual, (2nd edn) by M. McCaffrey & C. Pasero. 1999. C. V. Mosby, St Louis","volume":"9","author":"Herbert C.","year":"2000","unstructured":"Herbert C. Pain: clinical manual, (2nd edn) by M. McCaffrey & C. Pasero. 1999. C. V. Mosby, St Louis. ISBN 0 8051 5609 X. Pp. 796. \u00a321.95. J Clin Nurs. 2000; 9(4):650."},{"issue":"3","key":"B8","series-title":"Phys Med Rehabil Clin N Am.","first-page":"367","article-title":"The anatomy and pathophysiology of neck pain","volume":"22","author":"Bogduk N.","year":"2011","unstructured":"Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2011; 22(3):367\u2013382."},{"key":"B9","series-title":"Management of acute and chronic neck pain: an evidence-based approach.","author":"Bogduk N","year":"2006","unstructured":"Bogduk N, McGuirk B. Management of acute and chronic neck pain: an evidence-based approach. Amsterdam (Netherlands): Elsevier; 2006."},{"key":"B10","series-title":"IASP Task Force for Taxonomy: pain terminology.","author":"Merskey H","year":"2004","unstructured":"Merskey H, Boduk N. IASP Task Force for Taxonomy: pain terminology. Washington (DC): International Association for the Study of Pain; 2004."},{"key":"B11","series-title":"Bonica\u2019s management of pain.","author":"Ballantyne JC","year":"2019","unstructured":"Ballantyne JC, Fishman SM, Rathmell JP. Bonica\u2019s management of pain. 5 ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2019."},{"issue":"1","key":"B12","series-title":"BMC Musculoskelet Disord.","first-page":"56","article-title":"Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study","volume":"16","author":"Meisingset I","year":"2015","unstructured":"Meisingset I, Woodhouse A, Stensdotter A-K, Stavdahl \u00d8, Lor\u00e5s H,  Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study. BMC Musculoskelet Disord. 2015; 16(1):56."},{"issue":"3","key":"B13","series-title":"Pain.","first-page":"277","article-title":"The McGill Pain Questionnaire: major properties and scoring methods","volume":"1","author":"Melzack R.","year":"1975","unstructured":"Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975; 1(3):277\u2013299."},{"issue":"4","key":"B14","series-title":"Pain.","first-page":"345","article-title":"The West Haven-Yale Multidimensional Pain Inventory (WHYMPI)","volume":"23","author":"Kerns RD","year":"1985","unstructured":"Kerns RD, Turk DC, Rudy TE. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Pain. 1985; 23(4):345\u2013356."},{"issue":"7","key":"B15","series-title":"J Manipulative Physiol Ther.","first-page":"409","article-title":"The Neck Disability Index: a study of reliability and validity","volume":"14","author":"Vernon H","year":"1991","unstructured":"Vernon H, Mior S. The Neck Disability Index: a study of reliability and validity. J Manipulative Physiol Ther. 1991; 14(7):409\u2013415."},{"issue":"2","key":"B16","series-title":"J Chiropr Med.","first-page":"49","article-title":"Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools","volume":"9","author":"Misailidou V","year":"2010","unstructured":"Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010; 9(2):49\u201359."},{"issue":"2","key":"B17","series-title":"BMJ Open.","first-page":"e039488","article-title":"Development of a patient-reported outcome measure for neck pain in military aircrew: qualitative interviews to inform design and content","volume":"11","author":"Dowling A","year":"2021","unstructured":"Dowling A, Slungaard E, Heneghan NR. Development of a patient-reported outcome measure for neck pain in military aircrew: qualitative interviews to inform design and content. BMJ Open. 2021; 11(2):e039488."},{"issue":"June","key":"B18","series-title":"Front Public Health.","first-page":"1","article-title":"Best practices for developing and validating scales for health, social, and behavioral research: a primer","volume":"6","author":"Boateng GO","year":"2018","unstructured":"Boateng GO, Neilands TB, Frongillo EA, Melgar-Qui\u00f1onez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: a primer. Front Public Health. 2018; 6(June):1\u201318."},{"key":"B19","series-title":"J Bone Joint Surg Am.","first-page":"63","article-title":"Pain generation in lumbar and cervical facet joints","volume":"88","author":"Cavanaugh JM","year":"2006","unstructured":"Cavanaugh JM, Lu Y, Chen C, Kallakuri S. Pain generation in lumbar and cervical facet joints. J Bone Joint Surg Am. 2006; 88(Suppl. 2):63\u201367."},{"issue":"6","key":"B20","series-title":"Spine (Phila Pa 1976).","first-page":"453","article-title":"Cervical zygapophyseal joint pain patterns I: a study in normal volunteers","volume":"15","author":"Dwyer A","year":"1990","unstructured":"Dwyer A, Aprill C, Bogduk N. Cervical zygapophyseal joint pain patterns I: a study in normal volunteers. Spine (Phila Pa 1976). 1990; 15(6):453\u2013457."},{"issue":"1","key":"B21","series-title":"Pain Practice.","first-page":"21","article-title":"Differential diagnosis of local cervical syndrome versus cervical brachial syndrome","volume":"1","author":"Sizer PS","year":"2001","unstructured":"Sizer PS, Phelps V, Brismee JM. Differential diagnosis of local cervical syndrome versus cervical brachial syndrome. Pain Practice. 2001; 1(1):21\u201335."},{"issue":"3","key":"B22","series-title":"Pain.","first-page":"249","article-title":"Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy","volume":"6","year":"1979","unstructured":"Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain. 1979; 6(3):249\u2013252."},{"issue":"18","key":"B23","series-title":"Spine (Phila Pa 1976).","first-page":"2128","article-title":"Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions","volume":"22","author":"Van Tulder MW","year":"1997","unstructured":"Van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine (Phila Pa 1976). 1997; 22(18):2128\u20132156."},{"key":"B24","article-title":"Development and initial utilization of the Operational Neck Pain Index","author":"Whitley PE","year":"2024","unstructured":"Whitley PE, Shender BS, Shivers BL. Development and initial utilization of the Operational Neck Pain Index. Patuxent River (MD): Naval Air Warfare Center Aircraft Division; 2024. Report No. NAWCADPAX\/TIM-2024\/131."}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/5\/article-p367.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/5\/article-p367.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/5\/article-p367.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:01:02Z","timestamp":1745884862000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/5\/article-p367.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":24,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6549.2025","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}