Printable pain diary template

The basic template for any kind of pain, whether it's new, recurring or chronic. One week on one page, plus a review sheet that turns lots of entries into a few clear numbers.

Pain diary

A4 landscape · 2 pages · prints fine in black and white · free, no sign-up

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What to track, and why

Sitting in front of a doctor, it's hard to remember the past few weeks. What sticks is usually the worst day, or today. A pain diary records what it was really like: how often, how bad, in what situation and what you did about it. That's the basis for any conversation about causes and treatment.

Severity on a fixed scale

0 to 10, used the same way every time. Whether your 6 is someone else's 6 doesn't matter; what matters is that your 6 in March means the same as your 6 in May.

Where it hurts and what it feels like

Exactly where, and is it stabbing, dull, burning, aching? These words often say more than the number.

The situation

What were you doing, or what had you just done? That's how you spot connections that are easy to miss day to day.

Medication and anything else that helped

Name, dose, time, and whether it got better. Heat, rest or movement belong here too.

Columns in this template

  • Time hh:mm
  • Severity 0–10
  • Where? body area
  • What does it feel like? stabbing, dull, aching …
  • What was I doing? situation, activity
  • Medication name, dose, time
  • What helped? heat, rest, movement …
  • Notes mood, sleep, anything unusual

How to fill it in

  1. Print page 1 once a week, and page 2 once a week for your review.
  2. Write things down close to when they happen, not in the evening from memory.
  3. Stick to one scale: 0 is no pain, 10 is the worst pain you can imagine.
  4. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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
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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.

Trustworthy sources

External pages from health services, medical societies and patient organisations. We are not affiliated with any of them.

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