Nolan · Scandinavian journal of pain 2020 · systematic review of case-control studies · n=9 studies

Are there differences in lifting technique between those with and without low back pain? A systematic review.

Cited 57 times in the scientific literature.

Level 4 - case-series / case-control

Systematic review of observational case-control and cross-sectional studies

PubMed 31730537 · doi:10.1515/sjpain-2019-0089 · record verified 2026-08-29

What was done

Authors conducted a systematic review across five databases and manual searches to evaluate differences in freestyle lifting technique (muscle activity and kinematics) between people with and without low back pain (LBP). Studies were appraised using the CASP tool for case-control studies.

What was found

Nine studies were included; heterogeneity precluded meta-analysis. Eight of nine studies reported differences: people with LBP lifted more slowly (n = 6 studies), used their legs more than their back during initiation (n = 3 studies), and jerked less (n = 1 study). Four larger studies of more severe LBP also found reduced spinal range of motion and greater, longer-duration trunk muscle activity.

Why it matters

Protective, stiffer, leg-dominant lifting patterns mirror standard occupational lifting advice, suggesting this style reflects cautious movement in response to pain rather than necessarily preventing it.

Limits

All included studies were cross-sectional or case-control comparisons, preventing determination of causality. Meta-analysis was not possible due to heterogeneity, initial searches were performed by a single reviewer, and participant sample counts and quantitative effect sizes were not provided in the abstract.

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