Chronic flight-related neck pain is a common, well-recognized problem in military aircrew. The reasons for flight-related neck pain are multifactorial; however, there are currently no evidence-based guidelines for its prevention or clinical management. This case study describes the novel use of a synthetic training device in the rehabilitation of a Chinook crewman with chronic neck pain. The patient is a 34-yr-old rear crewman with 10 yr flying experience in the Chinook helicopter. He has a history of intermittent neck and shoulder pain since 2009 following a rugby injury. Over the years he has self-managed recurrent episodes of neck pain. However, in November 2017 his pain was so severe that he could no longer continue flying. This pain made him unfit for flying duties for 18 mo and he received intensive rehabilitation and injection therapy. RAF Odiham's new flying simulator was used in his return to flying program, so enabling him to become fully fit and return to all flying duties. Management and treatment of chronic flight-related neck pain is challenging. This case study highlights the importance of a multifactorial management approach and how a synthetic training device can be used in the rehabilitation of rotary rear crew.