Pain Diary
Pain Diary
A pain diary may help you and your doctor find out what makes your pain better or worse. Use the diary and pain scale below to keep track of when you have pain, how bad it is, and what you are doing to treat it.
Pain scale| 0 | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
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| No pain | Mild | Moderate | Severe | Worst pain imaginable |
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Daily diary| Date, time: | |
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| Pain scale rating: | |
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| Medicine and dose: | |
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| Medicine side effects: | |
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| What made the pain better today? | |
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| What made the pain worse today? | |
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Daily diary| Date, time: | |
|---|
| Pain scale rating: | |
|---|
| Medicine and dose: | |
|---|
| Medicine side effects: | |
|---|
| What made the pain better today? | |
|---|
| What made the pain worse today? | |
|---|
Daily diary| Date, time: | |
|---|
| Pain scale rating: | |
|---|
| Medicine and dose: | |
|---|
| Medicine side effects: | |
|---|
| What made the pain better today? | |
|---|
| What made the pain worse today? | |
|---|
Daily diary| Date, time: | |
|---|
| Pain scale rating: | |
|---|
| Medicine and dose: | |
|---|
| Medicine side effects: | |
|---|
| What made the pain better today? | |
|---|
| What made the pain worse today? | |
|---|
Credits
| By | Healthwise Staff |
| Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
| Specialist Medical Reviewer | Nancy Greenwald, MD - Physical Medicine and Rehabilitation |
| Last Revised | January 20, 2011 |
