VA Disability Rating
VA Disability Rating for Back Pain (Lumbosacral Strain)
Lower-back and neck strain is among the most-claimed VA conditions, rated primarily on your range of motion and flare-ups.
Diagnostic code 5237 · §4.71a · Musculoskeletal system · up to 100%
How the VA rates Back Pain (Lumbosacral Strain)
The VA assigns one of these ratings for Lumbosacral or cervical strain, based on the severity of your condition. These criteria are summarized from §4.71a:
| Rating | When 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 |
Conditions commonly connected to Back Pain (Lumbosacral Strain)
Back Pain (Lumbosacral Strain) is frequently claimed alongside, or as a secondary to, these conditions. If you have any of them, they may be separately ratable:
Radiculopathy (sciatic nerve)Radiculopathy (femoral nerve)Hip condition (altered gait)Knee condition (altered gait)Degenerative disc diseaseIntervertebral disc syndromeErectile dysfunction (nerve compression)Depression (chronic pain)
How to strengthen a Back Pain (Lumbosacral Strain) claim
The rating you receive depends almost entirely on your evidence and your C&P exam. To put your best claim forward:
- Get a current diagnosis and make sure your symptoms are documented at their worst, not your best day.
- Prepare for your C&P exam — the examiner's report usually decides your rating.
- If service connection isn't obvious, a nexus letter can link the condition to your service.
- If this condition was caused by another rated condition, file it as a secondary claim.
Peer-Reviewed Research on Back Pain (Lumbosacral Strain)
12 peer-reviewed studies linked to Back Pain (Lumbosacral Strain) (diagnostic code 5237) in the VA Ready app, sourced from PubMed and the U.S. National Library of Medicine. Every citation is real and links to the source — bring them to your C&P exam or hand them to your VSO.
Meta-analysisPrimary2026
Spinal manipulative therapy for adults with chronic low back painCochrane 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
Why it matters: Highest-tier evidence informing VA/DoD non-pharmacologic LBP guidelines
View on PubMed ↗Systematic reviewPrimary2025
Whole body vibrations and lower back pain: a systematic review of the current literatureBMJ 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
Why it matters: Nexus evidence linking military occupational vibration to LBP service-connection
View on PubMed ↗Cross-sectionalPrimary2024
Seventeen-Year National Pain Prevalence Trends Among U.S. Military VeteransThe 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
Why it matters: Largest national veteran pain trend study; supports LBP as high-prevalence service-connected MSK condition
View on PubMed ↗Systematic reviewPrimary2024
Prevalence and risk factors of low back pain in military personnel: a systematic reviewEFORT 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
Why it matters: LBP highly prevalent in military service, supporting service-connection presumption
View on PubMed ↗Randomized trialPrimary2024
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 intensityBMJ 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
Why it matters: RCT evidence specific to active-duty LBP reinforces in-service chronic LBP onset
View on PubMed ↗Systematic reviewPrimary2024
Prevalence and related factors for neck pain in military personnel: a systematic reviewEFORT 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
Why it matters: Cervical strain highly prevalent in service; supports service-connection
View on PubMed ↗Cohort studyPrimary2023
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-upMilitary 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
Why it matters: LBP is high-incidence in-service condition with sustained care needs
View on PubMed ↗ReviewPrimary2021
A Novel Biopsychosocial Approach to Neck Pain in Military Helicopter AircrewAerospace 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
Why it matters: Nexus evidence linking aviation occupational exposures to cervical strain
View on PubMed ↗Cross-sectionalPrimary2021
Cervico-thoracic pain and associated impairments in air force personnel: a cross-sectional studyBMC Musculoskeletal Disorders · 2021
- Highly prevalent cervico-thoracic pain across air force personnel
- Associated with reduced cervical ROM, strength, endurance
- Supports targeted neck-strengthening interventions
Why it matters: Documents service-related cervical strain across air-force including non-flying
View on PubMed ↗Meta-analysisSupporting2025
Effectiveness of Nonsurgical Interventions for Patients With Acute and Subacute Sciatica: A Systematic Review With Network Meta-AnalysisJournal 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
Why it matters: Top-tier evidence on conservative management of acute sciatic radiculopathy
View on PubMed ↗Meta-analysisSupporting2025
Effectiveness of non-surgical interventions for patients with chronic sciatica: A systematic review with network meta-analysisThe 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
Why it matters: Foundational evidence for chronic sciatica management for 8520
View on PubMed ↗ReviewSupporting2022
Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated OverviewCureus · 2022
- Sciatica risk factors: occupational lifting, prolonged sitting, disc disease
- Primary prevention through ergonomics; secondary management options
- Lifetime prevalence 13-40%
Why it matters: Etiology/risk-factor framework supporting service-related origin of sciatic radiculopathy
View on PubMed ↗
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Common questions
What is the VA rating for Back Pain (Lumbosacral Strain)?
The VA rates Lumbosacral or cervical strain under diagnostic code 5237 (§4.71a). Ratings run up to 100%, assigned from the criteria in the table above based on the severity of your condition.
What diagnostic code does the VA use for Back Pain (Lumbosacral Strain)?
Diagnostic code 5237, rated under §4.71a of the VA Schedule for Rating Disabilities.
Can Back Pain (Lumbosacral Strain) be claimed as a secondary condition?
Yes. Back Pain (Lumbosacral Strain) is commonly connected to conditions like Radiculopathy (sciatic nerve), Radiculopathy (femoral nerve), Hip condition (altered gait). A secondary claim needs a medical nexus linking it to your service-connected condition.
This page is for general informational purposes only and is not legal or medical advice. Rating criteria are summarized from 38 CFR Part 4; the VA determines actual ratings based on your evidence and exam. VA Ready is not affiliated with the U.S. Department of Veterans Affairs. Always verify current criteria at VA.gov and consult a VA-accredited representative.