What to Actually Record in a Pain Diary (and What to Skip)

By Andre Minoli · Medically reviewed by Mary Carol Jennings, MD, MPH

Short version: a useful pain diary records severity, activity, sleep, and one line of context, plus location or the words for how it feels, if those change for you. That’s the whole core. Nearly everything else people put in tracking templates is either a field you should add later, once the habit is solid, or a field that will quietly help you quit.

This post is the field-by-field reasoning. For the daily system around it — when to log, how to keep it under two minutes — start with the tracking guide.

The test a field has to pass

Before any field earns a daily slot, it should pass three questions:

1. Could it change a decision? Yours or your doctor’s — pacing, timing, spotting a trigger, evaluating a medication change. Clinicians often lack enough data about a patient’s pain to assess and manage it well — a diary exists to close exactly that gap, though closing it still depends on what you say in the appointment. If you can’t imagine the answer mattering, it’s dead weight.
2. Can you log it in seconds? Anything that requires thought, math, or scrolling gets skipped on bad days — which are exactly the days you most need recorded.
3. Will you still be logging it in week six? Be honest. The diary that works is the one that survives.

Most fields in elaborate tracking templates fail question three.

The core four (plus two)

Severity, on a coarse scale. None to severe in a handful of steps — not 0–10. You can’t reliably tell a 5 from a 6 day after day, and false precision just adds noise. A rating you can apply the same way in week one and week twelve is what makes trends real.

Activity. One line about what the day involved: “desk day,” “long drive,” “overdid the yard work.” Activity is the variable you can actually adjust, and lag patterns — today’s exertion, tomorrow’s payment — are invisible without it.

Sleep. Even just “good / rough / terrible.” Sleep and symptoms feed each other in both directions, and this coupling is one of the first real patterns most people find.

One line of context. The catch-all: a stressful call, a storm coming in, a skipped meal, a medication change. This field is where trigger candidates come from. Keep it to a line — it’s evidence for later, not a journal.

Location — only if it varies. If your pain migrates, where it showed up is real signal. If it’s always the same two places, the field is dead weight; skip it.

What it feels like — only if it changes. Aching one week and burning the next is a change a clinician will want to hear about, and the words are clues they actually use. Pick one or two words from a short list rather than writing a sentence; that keeps it to seconds. If your pain always feels the same, skip this one too.

When a flare hits, add the extras that matter for flares specifically — onset, peak, and recovery time. That’s covered in what counts as a flare.

Worth adding later — deliberately

These are legitimate fields. They’re listed here, not above, because each one makes the daily habit heavier, and the habit is worth more than any of them. Add one at a time, once logging feels automatic, and only if you have an actual question it would answer:

• Stress or mood, as a simple scale — relevant for many people, but the field most likely to turn into agonized journaling. Scale, not essay.
• Cycle tracking, if hormonal patterns are plausible for you — this one genuinely needs months of data to show anything, so patience.
• Specific suspected triggers — running a personal experiment on caffeine, or a particular food? Add a yes/no field for it, run it for a month, review, then retire the field.
• Medication changes — better logged as a dated course (when it started, when it changed or stopped) than as a daily field. What matters is the date it changed, not a daily confirmation, and that date is what makes a before-and-after comparison possible later.

What to skip

The fields that kill diaries:

• A dozen separate symptom scores. Rating pain, fatigue, brain fog, stiffness, and nausea individually every night sounds rigorous and lasts about ten days. Rate your worst one or two; note the rest when unusual.
• Everything-tracking. Hydration, every meal, steps, screen time — unless you’re testing a specific suspicion, this is data hoarding. Automatic sources (your phone already counts steps) can be consulted later if a question ever arises; they don’t need manual slots.
• Journal-length entries. They feel meaningful, but they’re slow to write, impossible to scan across weeks, and the first thing skipped on a hard day. One line, every day, beats a page twice a week.
• Backfilled guesses. If you missed Tuesday, leave Tuesday blank. An unrated day is unknown — not fine, not terrible, unknown. Diaries padded with reconstructions look complete and lie.

Whatever holds the diary, keep the fields this lean

A paper notebook with one line per day does this perfectly well. So does a spreadsheet with five columns. An app’s advantages are the reminder, the enforced consistency, and pattern-spotting across months of entries. That’s what Flare - Chronic Pain Tracker is built for, and Flare 2.0 is shaped around the same lean list:

• The core, in one check-in. Tap Log, then Check in: symptoms on a five-level named scale (None, Bearable, Mild, Moderate, Severe), the words that describe them, medications, activities, and a note. If you only want a severity, Add a row still does it in a tap.
• Descriptions are picked, not written. Start from suggestions like aching, burning, or throbbing, or add your own, and tap the ones that fit that check-in.
• The one line of context has a home. Type a daily note, use a Quick note, or dictate with your keyboard. Journal gathers the notes so you can read weeks of context in one sitting.
• Adding a field is deliberate. Tracking templates let you preview a set of symptoms, medications, or activities and add only what’s useful, without replacing what you already track.
• Some context needs no slot at all. Connect Sleep and Weather and Flare sets them beside your ratings in Trends Pro once there’s enough data to compare, so you don’t have to type them.
• Blank stays blank. An unlogged cell stays Unknown by default. If an empty cell really does mean a symptom-free day for you, Settings → Behaviors lets you choose that.

But the fields are the point, not the container: small enough to survive daily life, chosen so that three months from now, the patterns have somewhere to show up.

Flare - Chronic Pain Tracker is a symptom-tracking tool, not a medical device. This article is general information, not medical advice — talk to your doctor about decisions affecting your health.