Can You Get Back Pain From Pushing A Wheelchair?

Is it common to get back pain after pushing someone in a wheelchair? This is a valid concern, so we have done some research on this topic.

Wheelchair pushing can cause back pain for caregivers if they do so incorrectly and are unaware of their limits. The factors that make pushing a wheelchair taxing include the type of wheelchair, the weight of the patient and the terrain. You can find out how to make this task easier here.

In this article, here is what we will cover:

Who cannot push a wheelchair safely
Scientific research about pain from pushing a wheelchair
How to prevent back pain while pushing a wheelchair
How to push a wheelchair safely
How to reduce back pain after pushing a wheelchair

Who Cannot Push A Wheelchair Safely?

Pushing a wheelchair, especially for prolonged periods of time, can be dangerous for the following individuals:

Pregnant Women
Elderly Individuals
People with pre-existing medical conditions that are affected by strenuous activity

Pregnant Women

It is generally recommended that pregnant women not help push a wheelchair – performing heavy manual labor during pregnancy is definitely not a good idea. All doctors forbid it, especially in the first trimester, which can be the hardest on a woman’s body.

Based on the data we reviewed, if you are pregnant and a caregiver, you should not be doing any weight-bearing activities. Even more so because often taking care of people in wheelchairs can also include lifting them when there is no ramp available.

Although there is some leeway at the beginning of the pregnancy, that gray area includes only the first three or four weeks. So if your role involves any heavy-duty lifting, make sure that you can take parental leave at any necessary point during or after that initial period is over.

Elderly Individuals

Additionally, as a general rule, it is not recommended that someone of advanced age push a wheelchair because our muscle mass decreases as we age. Our reflexes slow down, so the probability of injuring oneself in any way surges. Additionally, having slower reflexes can be potentially dangerous to the wheelchair user in case of an emergency.

People With Pre-Existing Medical Conditions

Since pushing a wheelchair requires some knowledge on how to distribute your weight correctly, if you experience back pain usually due to an unrelated disorder, you may be more susceptible to injuries while working with a heavy load. If you have any condition that is linked to back pain, such as the following, you may want to reconsider helping out someone with their wheelchair:

Osteoporosis
Muscle Strain
Ruptured discs
Arthritis

If your child or another loved one uses a wheelchair and requires your assistance, consider exploring motor-assisted wheelchairs or transport wheelchairs. We’ll talk more about these options later in this article.

Can You Over Exert Yourself When Pushing A Wheelchair?

The Spine Research Institute at Ohio State University conducted a study to determine how wheelchair pushing affects the back muscles, the spine, and the shoulders. According to this study, people generally cannot estimate how much force they need to exert before the load can injure them – most of the participants exceeded the recommended force by 20%, with this number being much higher for men than for women.

The study asked 62 participants to push a simulated wheelchair, which, in this case, consisted of a rig attached to a break, where the resistance of the weight increased as time went on (the handlebar that the volunteers were holding onto was at the average height of most wheelchairs).

While having difficulty with pushing, the majority of the volunteers did not give up at the recommended limit, which was found to be 760 pounds of force or 3,400 Newtons.

Because of this innate human trait of perseverance, pushing a wheelchair is more dangerous than it needs to be, and the likelihood of back pain afterward is very high. William Marras from Ohio State pointed out that:

“Today, patient handling is one of the most dangerous jobs for your back. It’s more dangerous than working in construction, more dangerous than mining or any of the other jobs we typically think of as difficult.”
Source – ScienceDaily

If pushing a wheelchair is so dangerous, why haven’t biomedical engineers and physical therapists changed something? And how did pushing a wheelchair become so dangerous in the first place?

Wheelchair Design Has Failed To Evolve

Another factor that can make pushing a wheelchair harder is the wheelchair user’s body weight. Over the past few decades, people who often need a wheelchair for assistance, have been getting heavier, but that is not the central problem.

While wheelchairs have also been accommodating to larger patients, their design has failed to evolve over time, thus increasing the likelihood of injuries to those pushing the chair.

Scientists who have experience with ergonomics have suggested several ways in which wheelchair design can better accommodate both the patients using them and the caregivers who need to take care of their backs:

Adjustable handles. Usually, the handle height in all wheelchairs is pretty much the same regardless of how tall the caregiver is, which can cause additional back problems when the caregiver also has to bend down, in conjunction with pushing a heavy load. Ergonomists have proposed adjustable handles as a solution to this issue, and this adjustment would make wheelchairs both easier and safer to push.
Motor-assisted wheelchairs. While motorized wheelchairs already exist, it would be helpful to have a hybrid of a manual wheelchair with an added motor to assist the person pushing it. This design would be more efficient because it would not require as much charging. It would also help alleviate some of the caregiver’s weight figuratively and literally.

Now, there are add-ons such as the EZ Lite Caregiver Joystick Mount that allow caregivers to use electric wheelchairs to assist their loved one. Newer models of wheelchairs have add-ons that can modify how the wheelchair moves and make it more comfortable for both the patient and the caregiver. As of the date of this article, there are no wheelchair designs that completely prevent back pain.

Where Can You Get Pain From Pushing A Wheelchair?

As we have already discussed, pushing a wheelchair has a high chance of giving caregivers back pain. Aside from causing back pain, pushing a wheelchair can also cause damage to the caregivers:

Shoulders
Wrists
Neck

When our body puts effort into pushing something heavy like a wheelchair, this causes our spine to compress and the spinal discs to rub together. The long-term wear and tear on the discs can be one of the main causes of back pain.

Additionally, while pushing a wheelchair, some people want to naturally lean forward if the handles are a bit too low for comfort. This added force can make their wrists and neck ache from the uncomfortable placement.

All of these effects of improper wheelchair pushing are reason enough to change something in the way it is done.

How To Avoid Back Pain While Pushing A Wheelchair

Firstly, it is recommended that you try not to lean forward no matter how much you feel like you should. The key to minimizing injuries is to keep your back as straight as possible, so standing up and correcting your posture is the best way to ensure you won’t get negative side effects later on.

You can also make sure that you are pushing with your whole body and not just with your lumbar region. Focusing on your feet and using your core strength is the key to pushing a wheelchair correctly and safely.

How To Push A Wheelchair Safely

There are a couple more things you need to know and remember before starting to assist someone with their wheelchair:

You will know that your handles are at the correct height if you can push the wheelchair comfortably and be able to tip the front wheels up while the patient is in the chair. Doing this is necessary if you have to go over a step or avoid something on the pavement or uneven terrain.
You should never let go without warning the patient first. This can be extremely dangerous, especially if the wheelchair is located on a slanted area because it can start rolling down and potentially into ongoing traffic, so be careful!
Be highly aware of your surroundings. Look ahead to spot uneven ground. Make sure the front wheels don’t get caught on uneven ground, or the wheelchair user could accidently get launched forward out of their wheelchair. And if a wheelchair user gets stuck on an uneven surface, the force required to get them unstuck can create more back pain.
Be mindful of people passing as you are pushing the wheelchair user. When pushing someone in a wheelchair, it can be tricky to remember to look out for the foot plates. They can often hit people walking by and cause discomfort for the wheelchair user.
Be mindful of whether the wheelchair brakes are on or off, and do not push if they haven’t been released. Give the wheelchair user enough time to release the brakes and make sure to communicate with them once both of you are ready to go.
If the terrain is extremely challenging, like when the ground is covered in gravel, the best approach is to tip the wheelchair back and pull it back over the bumpy terrain. Another way to make it easier to go across challenging terrain is to use an all terrain wheelchair.
Use an all terrain wheelchair when necessary. The MT Push and the GRIT Freedom Wheelchair are excellent examples of an all terrain wheelchair. The wheels are specifically designed for rough, uneven surfaces. The MT Push wheelchair is a great choice for those pushing someone in a wheelchair since it has a handle with hand brakes in the back.
Consider a lightweight wheelchair. Depending on the wheelchair users needs, using a wheelchair with a lightweight base will significantly improve your back pain. A lightweight transport wheelchair (like this one on Amazon) makes it easier for caregivers to load the chair into a vehicle and move easily while walking. Oftentimes, loading a heavy wheelchair into a vehicle that is not designed for a wheelchair user can cause back pain.
Avoid adding extra weight to the wheelchair. It’s amazing how much of a difference removing unnecessary items such as a purse or jacket from the wheelchair can make. When possible, remove excess items from the person’s wheelchair. If the person carries medical equipment, medication or other essential items in the pockets of their wheelchair, do not remove it under any circumstances.

When possible, plan ahead. If you have a clear plan of where you’re going, be sure to look online to locate accessible entrances. It is much easier and safer to use a wheelchair accessible ramp to enter a building rather than using stairs.
When going over stairs, it is a good idea to tip the chair backward and slowly climb the stairs one by one, ensuring that everything is at the same level to prevent falling over. Going down the stairs is a bit easier, and you can do it with the chair facing forward.
When going down a hill or ramp, always ask the wheelchair user if they want to travel down facing forwards or backwards. Depending on how steep the slope is, it is generally safer to travel going backwards. This way the wheelchair is rolling towards you. However, it is important to note that some wheelchair users won’t like traveling backwards if the hill is mildly steep. Also, whichever approach you take, be sure to go slow.
Communicating at all times with the person in the wheelchair is essential so that they can feel more comfortable with you and so that they have a better sense of their surroundings and where they are going.

If you want to see some of these techniques demonstrated, you can watch this YouTube video.

How To Reduce Back Pain After Pushing A Wheelchair

So, you have already assisted someone with their wheelchair, and you have started to notice some annoying back pain. You are probably wondering if it’s because of the wheelchair pushing, and it very well might be! There are a couple of things that you can do if you sense that your back has been injured:

Consider what else may be causing inflammation. If you have a lot of inflammatory foods in your diet, it can increase the severity of your back pain. To learn more about foods that can cause inflammation, you can check out this YouTube video here.
Check to see if you are deficient in Vitamin D. One common symptom of a Vitamin D deficiency is aches and pains…including back pain. If you want to learn more about the connection between Vitamin D deficiency and back pain, check out this video on YouTube.
Make sure that you are exercising daily. One thing that makes back pain worse is that it is definitely being idle for long periods. When your back hurts, your best bet is to do some mild exercise like walking, swimming, or yoga.
Make sure you have good posture throughout your day. For people who sit frequently for their work, it can be easy to forget to have good posture. And when you have poor posture and then push a wheelchair, it can be hard on your back. Also, having an ergonomic desk set up can help alleviate back pain. Here is a video guide on how to prevent back pain while sitting.
If you do not get better within two or three weeks, it is best to contact a medical professional and get yourself checked out.

Conclusion

Pushing a wheelchair can cause back pain, but you can minimize that risk by taking all the necessary precautions.

First, get educated on pushing a wheelchair safely and getting general advice on wheelchair etiquette from a person who is using one. Here is an article on some basic wheelchair etiquette.

Ensure that you know the person you are assisting and they feel comfortable around you. Pushing their wheelchair is something they fully have to trust you to do for them.

Second, to avoid back pain, do not lean in, adjust the handles on the chair, and use your core strength to your advantage.

Finally, if you do experience back pain, call your doctor and keep exercising regularly. This blog provides general information about health and related subjects. This article and any linked materials are not intended and should not be considered, or used as a substitute for, medical advice, diagnosis or treatment.