One of the most beneficial things that I started doing when first diagnosed with chronic pain (I actually started this years before the ‘official’ diagnosis) is to keep a pain journal. I found that it helped me in three ways:
- It helped me to track what I was doing before, during, and after the onset of the ‘breakthrough’ pain while also monitoring my daily intake of medications and I felt good doing it. It gave me a sense of control in intimately knowing what was happening, when it was happening, and how I was affecting it.
- It helped my doctor correctly diagnose me with chronic pain. I had seen doctors on and off for years, but when you go to a doctor with two years of excel spreadsheets showing your daily levels of pain and the amount of tylenol, excedrin, ibuprofen, vicodin, etc you took on a Sunday nine months ago it adds legitimacy to your claim that you’ve been suffering.
- The most valuable function to keeping a pain journal is the legitimacy it provides. It is extremely helpful to go to the doctor with a diary of exactly what happened during your day and how often you took your meds. When you go to the doctor at a later period and you start talking to them about meds before your scheduled refill (if you’re lucky enough to get to the refill stage) it is helpful for them to see that you have taken your breakthrough meds responsibly and that your count of the meds and what’s leftover in the bottle match up.
Aside from my reasons above for keeping a pain journal I found it to be really easy to do so! Sometimes people feel like it’s a daunting task to keep track of things that you do during the day and the times that you did them. In fact, this isn’t true. It can be quite easy.
A pain journal should contain the following information for your doctor:
- The day and date for the journal entry (usually the day of the week and the date at the top of the page) so that your doctor has some idea when episodes occur. Listing the actual day of the week is more helpful for you to remember what you did. For example, what did I do on 3/15/11? I don’t know but I can tell you what I did this past Tuesday.
- The pain level you experience throughout the day. This means coming up with a pain scale (typically 0 – 10 from no pain to the worst you have ever experienced) and marking it throughout the day. I used to do it twice a day (at breakfast and before bed). I now keep track of it every hour (as you’ll see later it is really easy to do).
- List what you did throughout the day and the times you did them. I personally don’t go crazy with this but it is useful to know that your lower back pain a 6pm could be due to soccer practice that ended at 4pm.
- Another important thing to keep track of is when and how much medicine you took throughout the day. More on this later.
- Not necessarily kept in the daily section of your pain journal but listing side effects to any medications can be handy.
- The last important and most overlooked part of the pain journal is how you feel. This can be done as a reflection at the end of the night. Were you more sad than usual? Did you avoid a specific activity due to pain or the fear of pain?
These are but a few but in my opinion the most important details to list in your pain journal. Now that you know what you should put in it, how will you do it? Well I have kept many pain journals and some have worked better than others. Remember: the BEST pain journal is the one you USE.
The first type of pain journal I kept was an excel spreadsheet. Since I was always around a computer, this was handy. However, I could only really keep track of the amount of pills I took everyday and my overall pain levels. I found that if I tried to go crazy in detailing my entire day, it became burdensome. Also, if you’re like me, you want to keep the journal handy but also discreet. I didn’t always have my computer with me and then it becomes a problem of remembering what you did during the day.
The next thing that I tried was using a small notebook that could easily fit in my back pocket. For this I used a mini Moleskin notebook that you can find at almost any bookstore or here. In this I would date each page by itself and then write line by line what I did. I would write: took Lortab (dosage) @ 3:15pm for example. I would also keep track of when I ate and my daily activities. This was nice because the notebook fit nicely in my pocket, was discreet, and easy to keep.
The next type of pain journal that I kept was on my cell phone. More on that in my next posting. This was by far the most convenient and accurate of all my pain journals. Again, I will do an entire posting on that one shortly!
The pain journal that I use right now (and by far my favorite thus far) is based on a template that I found from the American Pain Foundation. The template can be found here and is extremely detailed and easy to use. This one allows me to track my pain on a scale of 0 – 10 every hour of the day. It also lets me mark on the front or back of a human silhouette where the pain occurred. The other important thing about it is that it allows me to track when I take my different medications throughout the day. I use the daily template found on the site and print out 7 of them in small booklets. That way, I have a weeks worth of notes bound at once. This allows me to go to my doctor at the end of the month with four booklets of a very detailed history of my daily pain management. The booklet size is about 25% of a standard sheet of paper.
These are just a few of the ways I have found to keep a decent pain journal. I have found websites like MedHelp.org that have online pain journals but for me this just wasn’t as detailed as I wanted it or as convenient as I needed it to be. I have found it to be extremely helpful and slightly rewarding to track my progress through the years. Everyone is different in how they keep their notes. As I said before, the best pain journal is the one that you USE! If you have an idea that wasn’t listed here and works as well, please tell us in a comment.