Pain Control Diary
Overview
A pain diary may help you and your doctor find out what makes your pain better or worse. Use the diary below to keep track of when you have pain, how bad it is, and what you are doing to treat it.
This figure has been reproduced with permission of the International Association for the Study of Pain® (IASP®). The figure may not be reproduced for any other purpose without permission.
These faces show how much something can hurt. The face on the left shows no pain. The other faces in turn show more and more pain. The face on the right shows very much pain. You can use these faces to know what number to use to show how much you or a child hurts right now.
|
Date |
Time |
Pain scale rating |
Medicine and dose |
Other pain relief methods |
Side effects from pain medicine |
|---|---|---|---|---|---|
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|||||
|
|
|
|
|
|
Current as of: July 31, 2024
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
