Musculoskeletal disorders are the leading cause of work-related injuries, with the back being the most commonly affected area. To help workers who perform manual material handling activities, exoskeletons are increasingly being recognized as effective solutions. The EU project STREAM developed an exoskeleton and control strategies specifically for workers in railway worksites. In this work, by analyzing the electromyographic activity of the back muscles of workers performing their jobs, we demonstrate that a specific development on the user’s needs enormously enhances the exoskeleton performance by even a factor of two.