Your doctor needs detailed data to plot out the causes and triggers of your chronic pain and build a treatment plan. When she asks how you have been in the past month or two, you need to be ready to provide specifics.
"My back is bothering me worse than ever" won't help your doctor. One solution pain doctors recommend is keeping a pain diary, a consistent record of your pain experience.
Your doctor will be looking for triggers, stresses, and patterns. The more detailed you can be about the factors that seem to influence your pain, the better.
- Rate your pain on the pain scale at different times of the day.
- Indicate whether your pain interrupts daily activities like walking, working, or sleeping.
- Note what meds you took, when you took them, how much relief they provided, and for how long.
- Describe other treatments you may have tried (yoga, herbal remedies, nonprescription drugs), and whether they provided any relief.
- Note any side effects of pain medicine.
- Keep track of anything that makes the pain improve (better when you are sitting instead of standing, better after a hot shower, etc.)
Consistency is the key. If you make notes in your diary on a regular basis (several times a week), you'll have a complete picture of your pain experience and patterns will emerge.
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Watch for surprises and patterns
You may notice some unusual connections. The stress of making dinner in the evening may cause that stabbing pain to return, or an argument with your daughter may make your back hurt more than usual.
Andrea Cooper, 52, of Phoenix, Md., has found her pain diary invaluable for keeping track of her fibromyalgia. "I saw that my pain would peak at certain times of the day," she says. "Even when I was on pain medication, I still found the pain had an upward climb at the end of day. I was able to take that to the doctor, and when he looked at it he said 'Gee whiz, your pain medicine is not getting you through the day. We need to do something about that spike.' He changed my medication and things improved."
Don't get addicted to the pain diary
Cooper does warn, however, of the danger of focusing so much on your pain that you obsessively fill in an entry every hour of the day. "That can backfire," she says, because "we all know that focusing on something that's bothering us will make it worse."
Cooper takes quick notes during the day and then writes a longer entry at the end of the day.
Download a pain diary
The not-for-profit American Pain Foundation has an excellent pain notebook that you can download for free. Also check out our print-and-carry list of what to keep in your pain diary.