How to keep a pain diary that helps your doctor
When you live with pain, it's hard to sum up weeks of it in a ten-minute appointment. A pain diary gives you and your doctor something better than memory: a record of when the pain happens, how bad it is, what helps, and how it affects your life. Here's what to record, and how to keep it going without it taking over.
Why a pain diary helps
- It shows patterns: times of day, activities or weeks when the pain is worse or better.
- It shows whether treatment works, including how much a painkiller helps and for how long.
- It captures the impact on sleep, mood, work and everyday life, which matters as much as the number.
- It can help with a diagnosis, as NHS pain diaries point out, and with deciding what to try next.
What to record
NHS pain diaries ask for broadly the same details:
- Date and time.
- Where it hurts. Be specific, or mark it on a simple body outline.
- How bad it is, on a 0 to 10 scale, where 0 is no pain and 10 is the worst you can imagine. Use the same scale every time.
- What it feels like: aching, burning, stabbing, throbbing or shooting.
- What you were doing before it started or got worse.
- Medication: what you took and when. Rate your pain just before taking it, then again 30 to 60 minutes later.
- Side effects of any medicines.
- How it affected your day: sleep, mood, work, and anything you couldn't do.
How often to fill it in
It depends on why you're keeping it:
- If your pain medication is being reviewed, one NHS diary asks you to fill it in each time you take pain relief, or at least twice a day.
- If you're looking for patterns, a short entry once or twice a day is usually enough. An NHS pain service notes that you don't need to record every day forever: a diary is most useful during periods of change, such as a new medicine or a change in activity.
Don't get up at night to fill it in. Add the entry the next morning instead.
A simple template
| Date | Time | Where | Pain (0–10) | What it feels like | Doing before | Medication and effect | Sleep, mood, activity |
|---|---|---|---|---|---|---|---|
| Mon 3 | 08:00 | Lower back | 6 | Aching, stiff | Just woke up | Painkiller at 08:15, down to 4 by 09:00 | Slept badly, late for work |
| Mon 3 | 19:00 | Lower back | 3 | Dull ache | Short walk | – | Good evening |
Making sense of it
- Look at weekly averages, not single bad days.
- Note what helps, as well as what makes it worse: rest, movement, heat, pacing.
- Watch the balance of activity. Doing too much on good days and paying for it afterwards is a common pattern, and a diary makes it visible.
- Bring it to your appointment, with a short summary of what you noticed and the questions you want to ask.
Keep it sustainable
A diary shouldn't make you think about pain all day. Keep entries short, fill it in at the same times each day, and record the good moments too. If it starts to feel like a burden, ask your doctor or pain team what's most useful to track. For other symptoms, see how to keep a symptom diary, and for headaches, how to keep a migraine diary.
Get urgent help for sudden severe pain, chest pain, or pain with symptoms such as weakness, numbness, fever or difficulty breathing. This guide is general information, not medical advice.