Back pain when lifting: Building strength instead of fearing movement

Back pain when lifting: Building strength instead of fearing movement

Author: Philipp Schröder, PT | Updated on: November 12, 2026

Back pain when lifting often occurs when a load is unusually heavy or the body is not prepared for it. According to studies, what is more important than a single «correct» lifting technique is that the back, hips, and legs are accustomed to carrying weight. Therefore, we focus on gradual strength building, including using free weights, and practice hip hinge and trunk tension as tools that will help you feel confident when lifting.

A wrong movement while lifting a crate of water, and suddenly a sharp pain shoots through the lower back. Back pain when lifting are the classic reason for an urgent appointment in our Zurich practice. It is important to understand that the spine is naturally extremely robust. Pain only occurs when the acting load exceeds the current capacity of your tissue.

When lifting from the floor, the strong muscles of the thighs and buttocks should do the main work. If there is a lack of strength here or if a neighboring joint is blocked (such as a stiff ankle or an immobile hip), the lumbar spine compensate for the movement. We analyze in the Physiotherapy Waidfuss exactly these biomechanical chains.

Typical symptoms

• Suddenly shooting, stabbing pain in the lower back immediately upon lifting a load
• Restriction of movement and precautions after the acute event
• Muscle tension in the lower back, sometimes radiating to the groin

Our treatment relies on concrete craftsmanship and active training:

• Pain Modulation & Manual Therapy: In cases of acute blockages or lumbago, we reduce the extreme protective tension in the back muscles. We achieve this through gentle joint mobilizations of the lumbar spine and targeted trigger point treatments.

• Mobilization in preparation: For example, we use our exercise bike with adjustable crank length. This allows for gentle, pain-free mobility of the lower limbs without straining the back.

• Hebemechanic & Neuro-Integration: Before force is exerted, the brain must plan the movement. We integrate lightweight neurocentric approaches (balance training) to improve unconscious core stabilization before you even reach out.

• Specific strength training: With Free weights let's train the deadlift. This everyday movement is crucial to gradually and safely increase your back's tolerance limit.

Strategies and everyday practical tips for home:

• The inner corset (bracing): Before lifting, take a deep breath into your entire abdominal cavity (including laterally into your flanks) and tighten your abdominal muscles as if you were expecting a light nudge to the stomach. This pressure supports the spine from the inside.

• The hip hinge: Practice the movement of pushing your hips back (as if closing a car door with your buttocks) while keeping your back neutral. The knees bend only slightly.

What the studies on back pain when lifting show

For a long time it was believed that if you lift properly, you won’t get back pain. Research has taken a more nuanced approach. A Cochrane review of nine randomized studies involving over 20,000 employees found with moderate certainty that training in lifting techniques, with or without assistive devices, does not prevent back pain better than no training (Verbeek et al., 2011).

Even a rounded back when lifting is, according to current knowledge, not a clear risk factor: A systematic review found no evidence that more bending of the lumbar spine during lifting causes or maintains back pain; however, the certainty of the findings is low (Saraceni et al., 2020).

For you, this means that you don't have to be afraid of any movement. What matters is that your body gets stronger and accustomed to heavier loads step by step. The tips below help you feel confident when lifting, but they are not rigid rules.

Self-help: How to relieve back pain in everyday life

• Elevate near the body: Hold the load as close to your body as possible, rather than with your arms outstretched.

• Legs instead of back: Get on your knees and use your leg strength to lift the load.

• Activate hull: Just before lifting, contract your abdominal and back muscles slightly.

• Avoid rotational movements: Never lift with a bent and twisted back at the same time.

When should you see a doctor or go to physical therapy?

Seek medical or physical therapy help promptly if you experience any of the following after lifting: Pain radiating into the leg, a numbness occurs, strength in the leg or foot decreases, or the pain does not subside after one to two weeks despite rest.

Many of our patients also use our services to targetly build up their trunk and leg strength. Small group training.

The correct pattern of movement when lifting can be learned: In the Functional Movement Theory (FBL) We train exactly these everyday movements.

Frequently asked questions about back pain when lifting

1. What is the best first aid for acute lower back pain (lumbago) after lifting? Avoid strict bed rest. Many find the supine position (lying on your back with your lower legs placed at a 90-degree angle on a chair) to be relieving. Stay as active as your pain allows; movement usually helps more than rest.

2. Am I even allowed to train with weights if I have back pain? Yes, absolutely. Properly dosed and under clinical supervision in our practice in Wipkingen, free weights are a very effective tool for preparing the back for the stresses of everyday life in Zurich.

3. Is lifting with a rounded back fundamentally harmful? No. The spine should be allowed to curve. A systematic review found no evidence that a curved back causes or maintains back pain when lifting heavy objects (Saraceni et al., 2020). The important thing is to gradually get used to carrying heavier loads.

4. Do you also treat radiating pain into the leg (sciatica)? Yes. If the pain radiates into the leg after lifting, we use specific neurological and manual tests to check whether a nerve root is irritated and adjust the therapy accordingly.

5. How long will it take before I can lift heavy things again? That depends on the tissue damage. An acute muscle strain often settles down after 1-2 weeks. However, the sustainable development of core and leg strength to prevent relapses requires 8 to 12 weeks of regular training.

Do not let the fear of lifting dictate your daily life. The team at Physiotherapie Waidfuss on Hönggerstrasse in Zurich is your contact for biomechanical analyses and targeted strengthening of the lumbar spine. Book an appointment online now.

Sources

• Verbeek J. H. et al. (2011): Manual advice on material handling and assistive devices for preventing and treating back pain in workers. Cochrane Review. PubMed
• Saraceni N. et al. (2020): To flex or not to flex? Is there a relationship between lumbar spine flexion during lifting and low back pain? A systematic review. Journal of Orthopaedic & Sports Physical Therapy. PubMed