noigroup logo

No more squirting toothpaste

By David Butler Metaphor and language 02 Dec 2015

Like a toothpaste tube

At the end of my recent teaching tour in New Zealand, a seminar participant handed me this piece on postural pain from a local magazine.

“If you imagine bending a toothpaste tube, that is the same as bending your spine. When the tube has been bent into a position for a long time, it causes toothpaste to squirt out of the tube. That’s what happens to a disc in someone’s back – it squirts out the back when it is put under pressure for a long time. That places massive pain on the nerves. If people are getting to that degree, they might first have to have surgery before they can be assisted.”

S Harvey, quoting “postural structural specialist” M Owens in Technology’s a Pain in the Neck, Mindfood, December 2015.


It was quite deflating to read this after three weeks on the road teaching evidence based neuroscience education, pain stories, metaphor and transformative metaphor. Backs and necks are not like toothpaste tubes, discs don’t squirt, pain is not something which can be placed on a nerve. The need for spinal surgery is extremely rare.

How can we help?

This style of health writing is still common and health writers clearly believe they are helping their readers. How can we best reassure people that this is inaccurate and unhelpful and how can we help health journos get it right ?

-David Butler


Screen Shot 2015-08-28 at 5.14.26 pm
There’ll be no squirting toothpaste tubes at EP3 2016, just the most up to date Pain Sciences from world leaders in the field. Click on the banner above for details and to purchase your ticket now.


  1. How frustrating with all you know and all you have tried to teach that you still have to see metaphors like squirting toothpaste in the mainstream media. I felt your frustration in the June posting on the perils of explaining pain. Why does everybody just not “get” the message you are trying to spread about pain, particularly clinicians who should know better. You have been spreading this message for long enough, one would expect you would have reached the tipping point. For a long time I have wanted to alert you to “that Sugar Film” and the work of your fellow talented Australian Damon Gamaeu. Damon with his outstanding creativity has presented the message on the toxic nature of sugar in one two hour film that many researchers/scientists/specialists before him have tried to do for at least the last 10 years with little success. Damon has changed lives and started a conversation that needed to be had around the damage we do to ourselves through the sugar we put in our mouths without knowing it. I urge you to view this video and look at how Damon has presented his message and then try and do the same with explain pain. I think that many of the clinicians out there would like nothing more than such a movie about “explain Pain” against the background of modern neuro- scientific knowledge . I believe many who have attended your courses would utilize such a movie to start a conversation with our patients ( and referring physicians) who don’t get it despite our best efforts.
    Along with this I would be the first to hold up my hand to crowdfund such an enterprise. I use Damon’s movie now to start my clients looking at the effect of what they put in their mouths has on their pain, their ability to lose weight and get active and in some cases, their ability to control inflammation. A movie like this for Explain Pain could well provide the tipping point you need that the knowledge that we are trying to bring to our clients becomes common knowledge not privileged.

  2. An account of a mid-thigh amputation, no anaesthetic. Hypnosis only. A surgeon by the name of Ward, in London 1842. Short read and fascinating.

    By way of contrast, may I present –

    It’s got ‘ion technology’, so you know it’s good. Try to read that web page without laughing or crying… or both.

Your email address will not be published. Required fields are marked *


Product was added to cart.