Case Study: EMS Chief Blames Chronic Back Pain On Lifting Practices

Daniel McGuire was a field EMT for 23 years before chronic back problems brought the EMS career he loved to an abrupt end. After two painful failed back operations, doctors ruled out Daniel ever returning to the EMS work he’d enjoyed since high school and the sense of, ‘giving back to his community’.

Daniel started volunteering with Geneseo Fire Department, New York in 1978 and soon found himself looking forward to his next shift and the camaraderie shared with colleagues. His colleagues became his second family; eating together, looking after each other and sharing many experiences – both good and bad.

Daniel’s early days

In the early days of his EMS career, there was no equipment to help lift patients and a gurney that weighed 65lbs. empty. Patients needed to be physically lifted by a minimum of two EMTs, who often had to twist uncomfortably to place a stretcher in an ambulance. The regularity of the lifting and twisting placed incredible stress on the lumber area of the spine and hips, causing most EMTs to complain of aching backs. At the time they felt unable to say anything to superiors for fear of ‘losing face’. They felt if it was revealed they had an injury, others may think they weren’t up to the job.

In 1987 Daniel moved to Henrietta Volunteer Ambulance; a much larger agency with over 5,000 call outs a year. As well as his volunteer work he was a Sales Representative at Eastman Kodak, but much preferred his life now as an EMT- Intermediate. By now, the pain in his back and knees was becoming unbearable and increasingly difficult to manage. He used ice, heat and medication to manage the pain but continued to put patients first – whatever they weighed – and the trauma to his back continued to worsen.

Eventually, surgery was the only solution. After two operations on his spine, Daniel was told his back was too fragile to return to the job he loved and he would never work in the field again. He returned to administrative duties but began to sink into a depressed mood, terribly missing the active EMS field work. He started to notice how the physical and demonstrative stress of the work affected other EMTs and paramedics. The physical pain was only surpassed by emotional pain and marriage breakdowns, chemical dependency and suicides were beginning to rise among the ranks.

After Kodak folded 15 years ago, Daniel started to work for himself and founded CISM Perspectives, Inc. (www.cismperspectives.com) in Rochester, New York. His aim is for EMS, Fire and Law Enforcement agencies to make the wellbeing of the EMT the priority and to gain recognition from first level supervisors about the issues a ‘macho EMS culture’ fosters. He is passionate about eliminating the stigma attached to admitting a call has had an adverse effect and talks to agencies, regardless of their size about setting up peer support teams.

Daniel believes that there have been great improvements in equipment provision to better protect the health of the emergency responders, and yet many EMS agencies are slow to promote a culture of safety often due to the overall costs to do so. As someone who is in constant, at times, debilitating pain because there wasn’t the right equipment available when he was a field EMT simply due to such equipment had not been designed/built and emergency responder wellness, especially physical wellness didn’t have the focus it does now. He is an enthusiastic advocate for safe lifting, regularly speaking at conferences across the US.



  1. Tom Loughmiller says:

    I was a paramedic in Kansas City Missouri for over 26 years and forced into early retirement in 2018. Kansas City is a high volume ambulance based EMS system with calls well over 30,000 a year. After many months of therapy work comp doctors Release Me saying that my injuries were not job related. Which you and I know is ridiculous.

  2. Linda Norcross says:

    Daniel McGuire, I 100% agree with you lifting practices need to be addressed. I like you also live everyday with chronic back pain this is why I am up at this time writing this comment.
    I started full time in EMS in 1986 worked 1 year for a private Ambulance Co. as an EMT. I at 22 years old then worked full time for a very busy city with a population of approximately 100,000.00 people with 3 ambulances during the day and dropped to 2 ambulances at night. I worked for this city from 1987 to 2016. Within those years I became a EMT Intermediate then a EMT Paramedic. In December of 2016 I was forced to retire service connected injury due to 3 failed back surgeries, each 7 months apart. I had 3 laminectomy, discectomy L2-3 L4-5. My back injury was due to wear and tear of lifting and carrying for 28 years full time and every overtime I could take. Our EMS Department worked a 4 days on 4 days off shift. We rotated 2 10hr days then 2. 14 hr nights then the 4 days off. I loved this shift it allowed your body/ back to rest the 4 days off if needed. Then around 2013, 2014 ? the service was forced to adopt a 40 hr week schedule 8-4 4-12 12 – 8 am 2 days off like most jobs. This is when my back pain/ injury increased because it was never aloud to rest.
    The injury I sustained was due to lifting practices I wish during any or all of the training classes I had including 28 years of refresher courses I wished there would have been more training not only on how to properly use a carrying device but how to PROPERLY use our bodies to lift and carry these devices as well as patients. I think it is assumed that people already know proper lifting practices. I also believe you can totally lift properly and still sustain an injury. I wanted to comment and to let you know you are not alone i also went and still go through similar feelings and issues like you due to my injury. I miss the EMS service terribly it was my life, my family, my friends and I am reminded everyday because of this back and leg pain. We have had several people go out service connected injuries all due to lifting practices.

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