Lifting, bending and carrying

Lifting is one of the most common moments when people feel their backs twinge: a bag of compost, a suitcase into a car boot, a box during a house move, a heavy pan from a low cupboard. Public health guidance on lifting is simple, and most of it comes down to sizing up the load, keeping it close and avoiding a twist.

Why lifting strains the back

MedlinePlus, in its guide to lifting and bending the right way, notes that many people injure their backs when they lift objects the wrong way. It explains that past injuries to the muscles, ligaments or disks of the spine can play a part, and that as people get older their muscles and ligaments become less flexible and their disks less elastic, which makes the back more prone to injury. The further a load is held from the body, and the more the spine is bent or twisted while it is held, the harder the muscles and discs of the lower back have to work.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases, in its overview of back pain, lists jobs that require heavy lifting, pushing, pulling or twisting among the job-related risk factors for back injury.

Size up the load first

MedlinePlus's first piece of advice is to know how much you can safely lift, thinking about what you have lifted before and how easy or hard it was, and to get help if an object seems too heavy or awkward. In practice, that means pausing before you lift to test the weight by tipping or nudging the object, checking whether it will shift or slosh inside, looking at the route you will carry it along, and clearing anything you might trip over. Splitting a load into smaller parts, using a trolley or wheelbarrow, or asking someone to share the lift are all ways of making it smaller.

How the lift itself is described

MedlinePlus sets out the steps of a careful lift:

• spread your feet apart to give your body a wide base of support;
• stand as close as possible to the object;
• bend at the knees rather than at the waist or back;
• tighten your stomach muscles as you lift and as you lower;
• hold the object as close to your body as you can;
• lift slowly, using the muscles of the hips and knees;
• do not bend forward as you stand up with the object;
• do not twist your back while you bend, lift or carry;
• squat to set the object down, again using the knees and hips and keeping the back straight.

The point about twisting deserves emphasis. Turning to put a load down on a bench beside you is one of the most common moments people describe hurting their backs. Moving the feet to turn the whole body keeps the load in front of you.

Warming up and conditioning

MedlinePlus also suggests warming up or stretching before lifting heavy weights, and notes that a better-conditioned body copes better with lifting. That is one reason why an afternoon of heavy work that the body is not used to, such as the first big garden clear-out of spring or a long day of moving house, so often leaves people sore. Spreading such jobs over several days, and taking frequent breaks, keeps any one session shorter.

Around the house and garden

• Shopping. Two lighter bags, one in each hand, are easier on the back than one heavy bag on one side.
• Luggage. Suitcases with wheels can be pulled rather than carried, and lifting a case into a car boot or an overhead rack is easier if you bring it close to your body first.
• Gardening. Kneeling on a pad instead of bending from the waist, using long-handled tools, and filling a wheelbarrow only partly all reduce the strain of digging and weeding.
• Low cupboards and the laundry. Kneeling or squatting to reach low shelves, and keeping heavy, often-used items between waist and shoulder height, saves many small bends a day.
• Snow and leaves. Pushing rather than lifting, taking smaller scoops, and turning with the feet rather than throwing over the shoulder.

At work

MedlinePlus advises that if your work requires lifting that may not be safe for your back, you should talk to your supervisor, and it notes that a physical therapist or occupational therapist can teach safe lifting for a particular job. Many workplaces use lifting aids, team lifts and training for exactly this reason. The work strain page explains how ergonomics looks at lifting and other physical tasks.

If a lift goes wrong

A twinge while lifting is often a strain of the muscles or ligaments of the lower back, the kind of soreness described on the low back pain page. But pain after a lift that is severe, that runs down a leg, or that comes with numbness, weakness or any change in bladder or bowel control needs prompt attention. The When to see a doctor page lists the warning signs.