Home / VA ratings by condition / Back Pain (Lumbosacral Strain)

VA disability rating for Back Pain (Lumbosacral Strain)

Lower-back and neck strain is rated primarily on your range of motion and flare-ups.

Diagnostic code 5237 · §4.71a · Musculoskeletal system · up to 100%

Rating criteria

RatingWhen it applies
100%Unfavorable ankylosis of entire spine
50%Unfavorable ankylosis of entire thoracolumbar spine
40%Unfavorable ankylosis of entire cervical spine; or forward flexion of thoracolumbar spine 30° or less; or favorable ankylosis of entire thoracolumbar spine
30%Forward flexion of cervical spine 15° or less; or favorable ankylosis of entire cervical spine
20%Forward flexion >30° but ≤60°; or combined ROM ≤120°; or muscle spasm/guarding severe enough for abnormal gait or spinal contour
10%Forward flexion of thoracolumbar spine >60° but ≤85°; or combined ROM >120° but ≤235°; or muscle spasm/guarding/tenderness not resulting in abnormal gait or spinal contour

Related conditions

Conditions often claimed with back pain (lumbosacral strain): Radiculopathy (sciatic nerve), Radiculopathy (femoral nerve), Hip condition (altered gait), Knee condition (altered gait), Degenerative disc disease, Intervertebral disc syndrome, Erectile dysfunction (nerve compression), and Depression (chronic pain).

A secondary claim needs a medical nexus linking the condition to a service-connected one.

Related guides

Peer-reviewed research on back pain (lumbosacral strain)

12 peer-reviewed studies linked to back pain (lumbosacral strain) (diagnostic code 5237), from PubMed and the U.S. National Library of Medicine. Each citation links to its source.

  1. Meta-analysis
    Spinal manipulative therapy for adults with chronic low back pain
    Cochrane Database of Systematic Reviews · 2026
    • Updated Cochrane review: SMT produces small short-term pain/function improvement for chronic LBP
    • Effects similar to other recommended therapies
    • Serious adverse events rare

    Highest-tier evidence informing VA/DoD non-pharmacologic LBP guidelines

    View on PubMed ↗
  2. Systematic review
    Whole body vibrations and lower back pain: a systematic review of the current literature
    BMJ Military Health · 2025
    • Occupational WBV exposure linked to lumbar pain
    • Helicopter pilots, AFV crew, fast jet pilots, boat crews at elevated risk
    • Cumulative WBV plausible mechanistic contributor to chronic LBP

    Nexus evidence linking military occupational vibration to LBP service-connection

    View on PubMed ↗
  3. Cross-sectional
    Seventeen-Year National Pain Prevalence Trends Among U.S. Military Veterans
    The Journal of Pain · 2024
    • 17-year national pain prevalence trends among US veterans via NHIS
    • Low back pain consistently among most-reported chronic pain sites
    • Veterans higher pain prevalence than nonveterans

    Largest national veteran pain trend study; supports LBP as high-prevalence service-connected MSK condition

    View on PubMed ↗
  4. Systematic review
    Prevalence and risk factors of low back pain in military personnel: a systematic review
    EFORT Open Reviews · 2024
    • Pooled LBP prevalence in military personnel 20-80% by cohort
    • Risk factors: heavy load carriage, prolonged sitting, training intensity, prior injury
    • LBP among leading causes of medical encounters and lost duty time

    LBP highly prevalent in military service, supporting service-connection presumption

    View on PubMed ↗
  5. Randomized trial
    Secondary causal mediation analysis of a pragmatic clinical trial to evaluate the effect of chiropractic care for US active-duty military on biopsychosocial outcomes occurring through effects on low back pain interference and intensity
    BMJ Open · 2024
    • Pragmatic RCT of chiropractic care for active-duty LBP
    • Reductions in LBP intensity and interference mediated biopsychosocial improvements
    • Supports manual therapies in military LBP care

    RCT evidence specific to active-duty LBP reinforces in-service chronic LBP onset

    View on PubMed ↗
  6. Systematic review
    Prevalence and related factors for neck pain in military personnel: a systematic review
    EFORT Open Reviews · 2024
    • Pooled neck pain prevalence in military personnel varied widely with elevated rates in aviation crews
    • Risk factors: helmet/NVG load, ejection/G-force, age, prior LBP, posture
    • Causes substantial duty limitation and grounding

    Cervical strain highly prevalent in service; supports service-connection

    View on PubMed ↗
  7. Cohort study
    Active Duty Service Members Newly Presenting With Low Back Pain in Fiscal Year 2017: Health Care Utilization, Access to Care, and Private Sector Costs Over 2-year Follow-up
    Military Medicine · 2023
    • Followed active-duty members with new LBP for 2 years
    • Substantial healthcare resource use within follow-up
    • Quantified private-sector costs absorbed by MHS

    LBP is high-incidence in-service condition with sustained care needs

    View on PubMed ↗
  8. Review
    A Novel Biopsychosocial Approach to Neck Pain in Military Helicopter Aircrew
    Aerospace Medicine and Human Performance · 2021
    • Helmet weight, NVG load, vibration, sustained postural loading drive cervical strain
    • Biopsychosocial framework recommended
    • Multidisciplinary approach to prevention and treatment

    Nexus evidence linking aviation occupational exposures to cervical strain

    View on PubMed ↗
  9. Cross-sectional
    Cervico-thoracic pain and associated impairments in air force personnel: a cross-sectional study
    BMC Musculoskeletal Disorders · 2021
    • Highly prevalent cervico-thoracic pain across air force personnel
    • Associated with reduced cervical ROM, strength, endurance
    • Supports targeted neck-strengthening interventions

    Documents service-related cervical strain across air-force including non-flying

    View on PubMed ↗
  10. Meta-analysis
    Effectiveness of Nonsurgical Interventions for Patients With Acute and Subacute Sciatica: A Systematic Review With Network Meta-Analysis
    Journal of Orthopaedic and Sports Physical Therapy · 2025
    • Network MA: epidural steroid, manual therapy, exercise had short-term benefits vs usual care
    • Evidence quality low-to-moderate for most comparisons
    • Multiple interventions evaluated

    Top-tier evidence on conservative management of acute sciatic radiculopathy

    View on PubMed ↗
  11. Meta-analysis
    Effectiveness of non-surgical interventions for patients with chronic sciatica: A systematic review with network meta-analysis
    The Journal of Pain · 2025
    • Network MA of nonsurgical interventions for chronic sciatica >12 weeks
    • Exercise therapy and combined interventions outperformed usual care
    • Modest pain reductions; no single superior modality

    Foundational evidence for chronic sciatica management for 8520

    View on PubMed ↗
  12. Review
    Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated Overview
    Cureus · 2022
    • Sciatica risk factors: occupational lifting, prolonged sitting, disc disease
    • Primary prevention through ergonomics; secondary management options
    • Lifetime prevalence 13-40%

    Etiology/risk-factor framework supporting service-related origin of sciatic radiculopathy

    View on PubMed ↗

Citations are provided for general educational use and are not medical advice.

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