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Click ‘Get Form’ to open the pain diary worksheet in the editor.
Begin by entering the date and time of your pain episode at the top of the form. This helps track patterns over time.
In the 'Pain Score' section, rate your pain on a scale from 0 to 10, where 0 means no pain and 10 represents the worst pain you've ever had. Use descriptive words like 'ache', 'sharp', or 'throbbing' to detail how it feels.
Document what you were doing when the pain began in the designated field. This context can be crucial for understanding triggers.
List any medications taken, including name and dosage, in the corresponding section to monitor their effectiveness.
Note any non-drug techniques you tried to alleviate your pain, such as relaxation exercises or heat therapy.
Indicate how long the pain lasted in minutes or hours, providing a clearer picture of its impact on your day.
Finally, use the 'Other notes' section for any additional observations or thoughts that may help in managing your pain.
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Dec 31, 2009 PAIN MANAGEMENT DIARY Page. DATE TIME SYMPTOM DESCRIPTION PAIN SCALE RATING LOCATION OF PAIN MEDICATION and DOSAGE NON-MEDICATION INTERVENTIONS
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