Recently a granddaughter aged six years came to me with a wiggly front tooth. A request to extract it was made. The boldness of the opening statement was not followed quite so assuredly when the pliers came out, but eventually the oral submission took place and tooth was removed in two seconds, once the cost to The Tooth Fairy was established! $5 for two seconds is an hourly rate of $1,500 per hour — not bad for a six year old.
Four days later, the adjacent tooth became even more wiggly, but neither presenter stepped forth with such immediacy. Our granddaughter’s older brother, who is about to study law at university unbeknowingly entered the negotiations, and an agreement was reached that if two teeth are pulled in the same week, that is twice the courage and therefore twice the payment due.
$10 for two seconds work is $3,000 per hour — a lot of money for any oral submitter.
For Rebecca and I it is remarkable how well educated New Zealanders are about oral hygiene compared with other health criteria, especially our spines. We know most people brush their teeth at least twice daily, floss regularly, mouthwash, gargle, and never eat sweet sugars immediately before going to bed at night. Society chlorinates, fluorinates, mandates regular teeth checks for the young because it is wise and cost effective to do so, yet we only have 32 teeth. Of these 32 adult teeth, there are eight incisors, four canines, eight premolars, and 12 molars. Of the 12 molars, there are four wisdom teeth. Compare this with the 33 spinal vertebrae, which articulate as a three-legged stool creating 99 joints.
Vertebrae: The spine has 33 stacked vertebrae (small bones) that form the spinal canal. The spinal canal is a tunnel that houses the spinal cord and nerves, protecting them from injury. Most vertebrae move to allow for a range of motion. Part of the lowest vertebrae (sacrum and coccyx) are fused together and don’t move, their surrounds only hesitantly.
Facet joints: These spinal joints have cartilage (a slippery connective tissue) that allows vertebrae to slide against each other. Facet joints let you twist and turn, and they provide flexibility and stability. These joints can develop arthritis and cause back pain or neck pain.
Intervertebral discs: These flat, round cushions sit between the vertebrae and act as the spine’s shock absorbers. Each disc has a soft, gel-like centre (the nucleus pulposus) surrounded by a flexible outer ring (the annulus). Intervertebral discs are under constant pressure. A disc can tear, allowing some of the nucleus’ gel substance to leak out. Herniated discs (also called bulging, slipped or ruptured discs) can be painful.
Spinal cord and nerves: The spinal cord is a column of nerves that travels through the spinal canal. The cord extends from the skull to the lower back. Thirty-one pairs of nerves branch out through vertebral openings (the neural foramen). These nerves carry messages between the brain and muscles.
Soft tissues: Ligaments connect the vertebrae to hold the spine in position. Muscles support the back and help you move. Tendons connect muscles to bone and aid movement.
Yet how much education do we receive about our spines when measured against our teeth. Even our hair receives more teaching and attention than our spines do on a daily basis. Our teeth and our hair can be replaced, the first by dentures the second by a wig, on which judges are expert. Our spines are irreplaceable and in most physiotherapist’s opinions, a poor cousin to the teeth in messaging.
Eighty percent of the civilised world’s population will suffer back pain sufficiently to seek treatment. These figures are more than pandemic, but we do little reduce costs financially or emotionally to address this issue. For females the problem compounds. Is there a judge who would favourably find for someone who increases their weight by 10-12 kg and constantly carries this over a nine-month period, bends the spine to impossible angles, then have the pelvis pull apart with 12 tons strain? Does this behaviour not require some form of committal to an institution! The aforementioned is pregnancy. The Scandinavian countries recognise the problem and all women post natal receive, along with the internals, a spinal examination and a recovery programme implemented. No wonder subsequent health costs in Scandinavia have been until recently some of the best benchmarks in the world.
So what is the solution here? Despite the evidence, the blind eyes of politicians are unlikely to rapidly open on this front, so take the law into your own hands. Tell your loved ones:
You only have one spine and one brain, the rest of your body is replaceable.
Brush your spinal joints as often as your teeth or hair. Yes we hear daily, “I’m a truck driver, builder, market gardener, farmer, teacher, judge, I use my spine all day. “Yes, just as you use your car, truck, tractor, chair, therefore no maintenance required?
Advocate for the less informed to be taught the inevitability of spinal pain under the current curriculum. Physiotherapists have failed, now we need the experts in advocacy to help. Best of all set a daily example of exercise for others in your sphere.
Put physiotherapists out of business. Any pain in the spine that persists for two days needs attention. While the pain may settle the cause is probably just being masked. Early treatment probably means less treatment.
Referred pain into the arm or leg is worse than central pain. Referred pain should be checked early. Numbness, paraethesiae, and loss of feeling or circulation, can be serious. Seek advice.
Back pain is not just psychological. Consider back pain as a back attack, just as heart pain is described as a heart attack. Sometimes an attack is far simpler pathology, but as judges you will appreciate a major case almost always has smaller precursors that did not just go away.
Puri whitiora
Keep fit
Malcolm and Rebecca.