Many people miscalculate the debilitating power of chronic pain, other than those of us who live with it daily. Pain can come in many forms, whether consistent or fluctuating, continuous or temporary, widespread over the body or localized to one region. It is not uncommon for emotional pain to coincide with physical pain. It is imperative for chronic pain sufferers to be proactive in their pain management. With all types of pain, Comprehensive Centers for Pain Management implements a “pain diary” for our patients as a vital protocol when the goal is to achieve long-term relief.
Diligently maintaining your journal entries will be difficult at first, most especially when you are already hurting. Often times, patients will question the motive behind the “Pain Diary” and seem to be a nuisance for some. However, the pain journal can be an immensely efficient tool for your healthcare provider in properly diagnosing, treating, and assisting in managing your pain. It will become easier with time, and more than likely, you will find that you require less descriptive entries as you uncover your medical needs through early comprehensive documentation.
The following paragraphs contain thorough instructions on getting started with your pain journal.
Assess your pain meticulously. This may be done by keeping a detailed chronic pain journal. This journal will include your perceived level of pain, perhaps on a scale of 0 (zero) to 5 (five), zero being no pain, 1 (one) being mild, 2 (two) being mildly moderate, 3 (three) being moderate, 4 (four) being moderately severe, and 5 (five) being extremely severe. Use scales for other prominent symptoms, as well, whether uncommonly or commonly accompanying your pain, such as immobility or stiffness, headaches, nausea, fatigue, and so on. Include the ‘who’, ‘what’, ‘when’, ‘where’, ‘why’, and ‘how’. This means being descriptive in your pain logging.
- What were you doing throughout your day, and, most specifically, within the hour or so before the onset or worsening of your pain? What treatments or therapies did you attempt to relieve the pain (i.e.: medications, heat/cold application, sleep, massage, etc.)? What other symptoms, if any, were present at the time of your pain (i.e.: nausea, heartburn, dry mouth, intense fatigue, fever, skin rash, etc.)? List even those that you may believe are seemingly irrelevant or unrelated to your pain. If an abnormal feeling, unusual sensation, or uncommonly occurring symptom emerges during your pain (i.e.: visual disturbances, hearing changes, etc.), be sure to be equally as descriptive with those symptoms, as well. It may indicate the advent of a different type of condition or a required change in treatments.
- When did pain commence or increase? When did it subside or decrease? Including the time duration of your pain is crucial in monitoring your condition’s progression. Include details of any fluctuations in pain levels individually, as separate entries in your journal.
- Where were you when the pain occurred? Include details of the surroundings, if the place is not one you frequent enough to be familiar with the details of those surroundings based on memory alone.
- Why do you believe the pain initiated or worsened? Formulate some educated notions on what may have been the cause of your pain (i.e.: migraine onset- Asian cuisine with added MSG, strong aromas, etc.; arthritic pain- overuse of joints, weather, etc.; other sorts of pain – increased stress level, forgotten dose of medication administration, missed another form of treatment, etc.).
- How did the pain present itself or intensify in severity? For example, was it a dull, constant pain or a sharp, shooting pain? It may be helpful to use analogies in your notes. For instance, an arthritis sufferer may log a journal entry including “…lasting morning stiffness leaving me so immobile I felt as if my back bones and hips had fused together” or “…it felt as though some sort of prying tool was inserted between my bones in these particular joints and was forcefully pushing them apart from one another”. A complicated migraine sufferer may write “…the pain was dull and constant on the left half of my head with an achy sensation in my neck and a piercing, shocking feeling in my left temple that felt like lightening”.
- Finally, to address the ‘who’, consider who was in your presence at the onset or worsening of your pain. This may sound unnecessary; however, if a person is wearing a particular fragrance (particularly with migraines) or, perhaps, is someone who typically causes your stress level to increase, they may inadvertently be an indirect trigger of your pain (in relation to a multitude of conditions).
Many conditions, long-term and short-term afflictions, manifest themselves in very similar manners, which can make identifying the issue quite a complex task. Development of your pain journal will assist in the discovery of what is prompting your pain, which treatments are effective and which are not, which behaviors or triggers to avoid, and, hopefully, how to alleviate at least some of your hurting to reach a more tolerable pain level and a more comfortable lifestyle.