Back pain diary template
With back pain, context is everything: does it get worse when you sit, lift or stand for a long time? This template asks exactly that.
Back pain diary
A4 landscape · 2 pages · prints fine in black and white · free, no sign-up
What to track, and why
Back pain rarely follows a straight line. It depends on posture, load, movement and time of day. Write down only the score and you lose the context that matters most to your doctor or physiotherapist. So alongside severity, this template records what you were doing, how much you moved and whether the pain spreads.
Load and posture
Sitting, standing, lifting, bending: note what came just before the pain. After a few weeks you'll see whether there's a pattern.
Exercise
Walks, exercises, cycling, with minutes. Movement can be both a trigger and a help; writing it down separately keeps the two apart.
Spreading, tingling, numbness
Does the pain run down your leg or arm, is there tingling or numbness? That gets its own column, not a higher number.
Time of day
Stiff in the morning, worn out by evening? Two entries a day show whether your back follows a daily rhythm.
Columns in this template
- Time hh:mm
- Severity 0–10
- Where? body area
- Spreading down the leg? tingling, numb?
- Load sitting, standing, lifting, bending
- Exercise what, how many minutes
- Medication name, dose, time
- What helped? heat, rest, movement …
- Notes mood, sleep, anything unusual
How to fill it in
- Print page 1 once a week, and page 2 once a week for your review.
- Write things down close to when they happen, not in the evening from memory.
- Stick to one scale: 0 is no pain, 10 is the worst pain you can imagine.
- Blank boxes are fine. A short, honest entry beats a perfect one you reconstruct later.
Then what? Making use of your filled-in sheets
Most templates stop at the filling-in part. But the value comes afterwards, when lots of rows turn into a few clear statements.
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Sum up each week
At the weekend, fill in page 2: days with pain, worst score, days you took painkillers. It takes five minutes and saves a lot of page-flipping at the appointment.
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Compare after four weeks
Lay the weekly reviews side by side. Does anything repeat, a weekday, an activity, a trigger? Mark it, but don't jump to conclusions: a pattern isn't proof of a cause.
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Three numbers for your appointment
Before you go, write at the top of the first sheet: how many days a month you had pain, how strong it was on average, and what you couldn't do because of it. Those three lines make a good opening.
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Take the sheets, keep a copy
Bring the originals and take a photo first. After any change in treatment, comparing old and new sheets shows whether anything has changed.
When paper gets too much
Paper is a good start. The tedious part is the analysis: adding up weeks, looking for patterns, sorting sheets. That's exactly what PainTrack does for you.
- Log an entry in seconds on your own scale: 0–10, yes/no or mild/moderate/severe
- Add circumstances, body location and medication to an entry, with reminders
- Your trend chart and weekly trends update by themselves
- With Pro: trigger analysis and a ready-made PDF report for your doctor
Free for iPhone and Android, no account needed. Your data stays on your device.
This template helps you document your symptoms. It doesn't diagnose anything and is not a substitute for medical advice. If you have new, very severe or unusual symptoms, contact a doctor, or call your local emergency number in an emergency.
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Trustworthy sources
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