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For me it is not the back, it's the knees. I put in a lot of Kohler Cimarron one-piece toilets by holding them to my chest with the tank draped over one shoulder. They are balanced well and I can even go up the stairs with them. But afterwards my knees give me hell.
And I agree, the hard part is centering the toilet over the flange and bolts. I put a piece of 3/8 lav supply over the bolts. It helps me line things up and then I just pull them out.
I dunno... I guess I'm lucky as I don't really have the pain problem. I generally straddle them, grab either side of the bowl just in front of the tank, straighten back, then pull them up and do the toilet waddle out of the bathroom to where I have enough room to pull them up to my chest and out from between my legs. Lord do I hate 24" bathroom doors... oughta be a law.
This is my reminder to myself that no good will ever come from discussing politics or religion with anyone, ever.