Few complaints benefit from good documentation as much as headache. The reason is simple: what counts for classification are things you can almost never assemble accurately from memory - how many headache days per month, how often painkillers were taken and what preceded the attacks.
A headache or migraine diary answers exactly those three questions. Here is how to set one up.
Why document headaches in particular?
- Headache days per month is the central measure of progress. Whether a preventive treatment is working almost always shows up there - not in the memory of the worst attack.
- Attacks are episodic. Weeks pass between appointments; without notes they blur into "so-so".
- Memory blurs after the attack. The onset, the duration and any warning signs are already hard to reconstruct the following day.
- The number of days with painkillers is medically relevant and can only be stated reliably from records.
What to record with every attack
- Start and end - this gives you the duration, an important way of telling headache types apart.
- Intensity on a fixed scale, usually 0–10.
- Location and character - one-sided or both sides, throbbing, pressing, stabbing.
- Accompanying symptoms - nausea, sensitivity to light or noise, visual disturbances before the attack.
- Candidate triggers and circumstances - sleep, stress, skipped meals, alcohol, weather changes, screen time, menstrual cycle.
- Medication - product, time, dose and whether it worked.
- Impact - could you work, did you have to lie down?
In PainTrack you cover point 3 with the tags for the type of pain (stabbing, dull, burning, cramping, pulling, pressing, throbbing) and point 5 with the tags for the circumstances (anxious, stressed, cold, warm, active, rested, slept badly, alcohol). Accompanying symptoms and medication go into the free-text note - keep to a fixed wording there, something like "ibu 400 at 14:10, better after 1 h". Consistent phrasing is considerably easier to scan later in the report.
Spotting triggers - without jumping to conclusions
The most common mistake when hunting for triggers is turning a single coincidence in time into a cause.
- A co-occurrence is not a trigger. A factor only becomes interesting once it turns up conspicuously often across many attacks - and is absent on comparable symptom-free days.
- Be careful with "cravings as a trigger". With migraine, the prodrome itself can create an appetite for particular foods. The chocolate is then an early symptom rather than the cause.
- Usually it is a combination. A short night plus a skipped meal plus stress - individual factors on their own often have no consequences.
- Do not cut things out prematurely. Dropping whole food groups on the basis of a suspicion restricts you unnecessarily. Better to discuss any suspicions with your doctor.
In practice that means: record the circumstances on all days, not only on attack days. Without the good days there is no comparison group - and then every factor looks like a trigger.
Keeping an eye on painkiller days
If painkillers or migraine medication are taken on many days per month, the headache itself can intensify and become more frequent - specialists call this medication-overuse headache. A rough warning threshold is use on ten or more days per month over several months.
That is exactly why noting every dose pays off: it turns a feeling ("I hardly ever take anything, really") into a countable number. If you get anywhere near that order of magnitude, that is not a reason to stop medication on your own - it is a good reason to raise the topic at your next appointment.
Setting it up in PainTrack
Not all headaches are alike. It has proven useful to separate the forms that feel clearly different to you - for instance one definition for "migraine" and one for "tension headache", each with its own colour and the 0–10 scale.
- The free version includes one active pain definition. If you have to pick one, take the form that troubles you most.
- With Pro you create unlimited definitions and see several trends together in one chart - which makes it visible whether both forms are really increasing or only one of them.
For a monthly look at your headache days, the activity heatmap for the past three months is handy: it shows at a glance on how many days anything was logged at all. The weekly trends tell you whether the current week is going better than the previous one; Pro adds a third comparison card as well as chart ranges across 90 days and the whole period.
What counts in the consulting room
Prepare three numbers and one sentence:
- Headache days in the past month - "14 out of 31 days."
- Days with acute medication - "on 8 days."
- Typical duration and severity - "usually 6 to 8 hours, severity 7."
- Change - "roughly the same number of days as the three months before, but longer attacks."
With PainTrack Pro you turn that into a PDF doctor's report for a freely chosen period from one week up to a year, optionally with charts. To see what that looks like, have a look at the sample report as a PDF. The ground rules for clean entries are in the guide How to keep a pain diary.
When not to wait for your next appointment
A diary is there for the long run, not for emergencies. Among other things, you should seek medical help immediately for a sudden, extremely severe headache, a headache with fever and a stiff neck, one with paralysis or speech or vision problems, one after a fall or blow to the head, and a headache that suddenly feels completely different from what you are used to.
Frequently asked questions
How long should I keep a headache diary? At least four weeks, preferably three months. Only across several cycles do frequency patterns and the effect of a preventive treatment become visible.
Do I need to log something on good days too? Yes. Without symptom-free days you can neither state the number of headache days nor sensibly test a trigger.
Can I mix migraine and tension headache in one entry? Better not. Separate them into two pain definitions - otherwise the trend averages two different complaints into a single curve.
Do my records stay private? Yes. PainTrack stores every entry encrypted on your device, without an account and without a server. You can additionally lock the app with Face ID or Touch ID.
PainTrack is not a medical device and does not replace medical diagnosis or treatment. The app is intended for personal documentation and self-observation.