How to Keep a Pain Diary
A useful pain diary records four things every day: where it hurt, how bad it was, what you did about it, and what else was going on. Keep each entry short and log at roughly the same time daily. Consistency matters more than detail, because a clinician reads the pattern, not the prose.
What to record each day
Record the location, the intensity, the character of the pain, and the context around it. Those four dimensions are what turn "I had a bad week" into something a clinician can actually work with.
Location means more than "pelvic". Pain that sits low and central, pain that radiates into the back or down a leg, and pain that shows up during bowel or bladder activity are different entries, and marking them separately preserves a distinction you would otherwise lose. Intensity is usually a 0–10 number; the number is less important than using the same scale the same way every time. Character is the adjective — stabbing, dull, burning, cramping. Context is everything around the pain: sleep, stress, activity, food, where you are in your cycle if you have one, and any medication or relief you used.
A daily field checklist
Most people log too much at first and quit within two weeks. This is the short list worth keeping.
| Field | Example entry | Why it earns its place |
|---|---|---|
| Pain location | Lower left pelvis, radiating to back | Distinguishes sites that may behave differently over time |
| Pain intensity | 6 at worst, 3 average | Peak and typical tell different stories |
| Pain type | Cramping, some burning | Descriptors are part of how clinicians take a history |
| Bleeding or flow | Heavy / spotting / none | Anchors the timeline for people who bleed |
| Energy | 2 of 5, cancelled plans | Captures impact when a pain number alone does not |
| Other symptoms | Nausea, urgency, pain with sex | These often go unmentioned in short appointments |
| Meds and relief used | Prescribed med at 9am, heat pad | Shows what you tried, not whether it worked |
| Did it help? | Some / none / a lot | Your own response record over weeks, not a single day |
| Possible triggers | Poor sleep, long drive | Context your future self will not remember |
How often to log
Once a day, at a fixed time, is the target. Evening usually works best because the day is complete and you can record the worst point rather than guessing at it mid-morning.
Daily entries on ordinary days are what make bad days legible. A diary that only exists during flares shows a wall of high numbers with no baseline, and no way to see whether flares are getting more frequent. If daily is unrealistic, a consistent every-other-day entry is worth more than sporadic detailed ones.
Keeping it going on a bad day
Lower the bar on purpose. A single number and one word is a valid entry, and it is far better than a gap.
The days you least want to log are the days the record most needs. Build the habit so it survives them: attach logging to something you already do, keep entries to under a minute, and never backfill a week from memory — mark the missing days as missing instead. A diary with honest gaps is more credible than one reconstructed after the fact.
Making the diary useful to a clinician
Bring a summary, not the raw log. Appointments are short, and a stack of daily entries is hard to read cold.
What travels well is a compact view: how many days in the last month had pain above your own threshold, where the pain concentrated, what the worst days had in common, and how symptoms lined up with your cycle if you have one. Leave the interpretation to your clinician. Your job is an accurate record; deciding what it means, and what to do about it, is theirs. If you are heading into a consultation, our guides on how to describe pain to a doctor and preparing for a specialist appointment cover how to present it.
Paper or an app
Either works. Paper wins on simplicity; an app wins on summarising months of entries without you doing the arithmetic.
If you use an app, check where the data is stored before you commit months of health information to it. Wrenly is built local-first: pain logs, body-map entries, cycle data, meds, symptoms, and notes are stored only on your phone, with no account and no cloud backend, and free export to CSV or PDF means the record stays yours.
Track it in Wrenly
Body-map pain logging, a fast daily log, and cycle or no-cycle tracking — with your health data stored only on your device.