A Simple Pain Diary to Bring to Your Doctor

A useful pain diary helps you describe what happened between appointments: where pain occurs, what it feels like, and what it changes about your day. It does not prove a diagnosis or require you to justify how much you hurt. NIH's pain information emphasizes that your own description matters and recommends noting patterns over time.

Download the printable one-week pain diary (PDF). Open it to read or print on US Letter paper. The text template below provides the same recording prompts if you prefer a notebook or a private note on your own device. No account or health-information upload is required.

Do not wait for a completed diary to get help

Call 911 for possible heart attack symptoms, including chest pain or discomfort, shortness of breath, or arm, jaw or back pain. Also call for possible stroke symptoms: sudden facial droop, one-sided weakness or difficulty speaking. Follow the CDC's heart attack and stroke guidance, even if symptoms improve.

Go to an emergency department now for back pain with new difficulty urinating, loss of bladder or bowel control, numbness around the genitals or anus, or symptoms in both legs. Do not drive yourself. NHS back-pain guidance identifies these as emergency warning signs. Sudden severe or rapidly worsening back pain, or back pain with fever or feeling very unwell, needs urgent same-day medical advice.

These examples are not a complete emergency checklist. If symptoms feel like an emergency, seek care instead of recording another entry.

Use the seven-day template

Write the week-starting date, then make a brief entry for each day, Day 1 through Day 7. Leave a gap if you miss a day; do not invent details. If a clinician has asked for a different schedule or specific measurements, follow that plan.

The worksheet helps organize observations for an appointment; it cannot diagnose a condition. If your care team asks for more detail, the Cambridge University Hospitals activity diary shows an hourly format covering activity, pain, medicines, relief measures and sleep.

If you prefer to write your own notes, copy these prompts for each day:

• Day/date and time: When are you making this entry?
• Location, sensation and timing: Where did it hurt, did it spread, what did it feel like, and when did it happen? Add an optional pain rating.
• Activity, function and sleep: What could you do or need to change? How was sleep?
• What you tried and response: Include medicines exactly as taken, with name, amount and time; note other measures and any change or side effect.
• New symptoms or changes: What differed from your usual pattern?

At the end of the week, complete the summary box: when it began; the main pattern and direction of change; the biggest activity or sleep limitation; and your main question. Take the notes to your appointment even if you only have one or two entries.

A completed example

Fictional example of a diary entry:

Notice the concrete activity details. “Skipped carrying groceries” may be easier to discuss than “a bad day.” This example demonstrates how to record symptoms, not how to treat them or decide whether care is needed.

Describe the pain in your own words

You do not need medical vocabulary. Point to the location or sketch it, describe whether symptoms stay there or spread, and choose words that fit: aching, burning, sharp, tight, throbbing or electric. Say whether the feeling is constant or comes in episodes.

Add the approximate onset and what you were doing at the time. An honest “I cannot remember exactly” is better than a precise guess. NIAMS' explanation of a back-pain assessment shows how location, onset, severity, aggravating factors and daily function inform a clinical history.

If you use a 0–10 scale, keep your personal interpretation consistent and pair the number with an activity. A rating is optional in this worksheet; it is not a test you can fail. NIH notes that no single test completely measures another person's pain.

Record sleep and medicines without changing the plan

For sleep, note a useful detail such as repeated awakenings or difficulty finding a comfortable position. Include something you managed as well as something you could not do. CUH's activity diary guidance includes sleep timing, awakenings and how rested you felt.

Record medicines as actually taken, not just the prescription instructions. Include over-the-counter products and supplements on a separate current list. Do not start, stop or change a dose to create a comparison in the diary. Ask your clinician or pharmacist about medicine questions; if you cannot recall a dose, write “unsure.”

Keep paper notes somewhere private. For digital notes, use a device and storage location you trust. Share through your care team's preferred channel rather than posting identifiable health details publicly.

If detailed tracking feels tiring

Use three fields: where it hurt; one activity or sleep effect; anything new. A short factual note is enough to begin a conversation. You can leave out ratings or reduce tracking if it makes you preoccupied or anxious, then discuss a manageable approach with your clinician.

If symptoms change location, record that instead of forcing everything into one label. Our guide to pain that moves around offers related questions to bring.

Prepare a one-minute appointment summary

Here is a fictional five-line summary:

1. The back discomfort began about three weeks ago; I do not remember an injury.
2. It is most noticeable during desk work and sometimes when standing up.
3. It has stayed about the same this week.
4. I am pausing work more often and carrying less shopping.
5. What should we check, and how can I stay active comfortably?

Bring your diary, medicines and supplements list, and your main questions. The NHS appointment-preparation guide recommends notes and asking for explanations when something is unclear.

Before leaving, check:

• What are the possible explanations, and what remains uncertain?
• Which activities and treatments are appropriate for me?
• What change should make me get help sooner?
• When and how will we review progress?

Repeat the next steps in your own words so misunderstandings can be corrected.

Common questions

Do I have to complete all seven days?

No. The week is a convenient organizing format, not a requirement for care. Bring whatever observations you have, and never delay an appointment or urgent assessment to finish it.

Can a pain diary diagnose the cause?

No. It supplies history for a clinician to consider alongside an examination and any appropriate tests. Two people with similar diary entries can have different explanations for their pain.

Should I record every sensation?

This worksheet asks for a short daily summary. Focus on meaningful changes and practical effects. If your care team needs event-by-event records, ask which details and schedule would be most useful.

Sources and further reading

• NIH: Pain
• NIAMS: Back pain diagnosis and treatment
• Cambridge University Hospitals: Activity diary guidance
• NHS: What to ask your doctor or healthcare professional
• CDC: Heart attack symptoms
• CDC: Stroke signs and symptoms
• NHS: Back pain