I wanted to talk about pain scales.

That’s one of the biggest things that people have an issue with when they come in, and I ask them to rate their pain on a scale of one to ten.

I hear, “I have high pain tolerance,” or “I don’t know what number it is.”

We go from zero, which means no pain, all the way up to ten. When people come into my office, we shouldn’t be seeing tens.

Tens are usually like emergency-type situations, and you’re in the hospital.

If someone says a ten, we know it’s not really a ten.

It’s probably a little bit lower down here.

If it is a ten and they’ve already gone to the hospital, then we’ve got more issues that we need to deal with.

Usually, people are anywhere between four to eight when they come into my office.

Now, here’s the biggest thing.

I don’t necessarily care whether it’s a four or whether it’s an eight. What I do care about is that it goes down. I need to know the starting point.

That’s why the numbers are so important because we need to make sure we track it along the way because I want it to get better.

I don’t care if you’re a two as long as I get you to a zero. I don’t care if you’re an eight, as long as I get you to a two and maybe a zero.

We have got to get this to get better.

This is how we can track progress.

This is also how we can tell if we have a setback.

If you’re being treated in the office, a week goes by, and you go from an eight to a six, the weekend comes up, you decide to go out of town, you do some skiing, and now we’re up to an eight?

Something happened, and we re-aggravated it with that skiing, and we can tell that just because we’ve been charting pain levels as you’ve been coming through, not even counting anything else that we’re going to do.

You want to try to be as accurate as possible, but no one’s going to hold you to that number.

Don’t worry about it. Just pick the one that best suits you.