Spinal pain (principally cervical and lumbar) has been identified for many years as an exceedingly pervasive problem among the rotary-wing community. A ten-year collaborative longitudinal occupational health survey was undertaken to study British Army helicopter pilots. This coincided with the newly-released to service U.K. Apache Mk 1 attack helicopter. Two cohorts, Apache pilots (AP, n=63) and non-Apache pilots (NAP, n=135), were followed longitudinally by interval questionnaires regarding spinal pain characteristics and associated occupational disability. Despite a newer generation aircraft and lighter helmet for the Apache, there were no appreciable differences of notable consequence identified between the two cohorts. The study was subject to a number of limitations, most notably poor response numbers in later iterations of follow-up. Nonetheless, the data illustrate that neck and back pain remain prominent maladies among these cohorts with notable percentages of both groups reporting flight-related pain and associated disability and flying restriction.