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Home Back Pain Journal Questions for My Doctor Questions for My Surgeon Find a Doctor

Back Pain Journal

When you visit the doctor, it can be helpful to have a record of your back pain. This diary will help you track the frequency and intensity of your pain. And it may reveal a pattern that will help you and your doctor identify a successful treatment plan.

Date

Duration

(Include start time/end time)

Type of Pain

(dull, aching, hot, throbbing)

How painful?

(Rate the pain:
1=mild,
2=moderate,
3=severe)

Possible Causes

(Did something trigger the pain?)

Medication

(What did you take? Did it help?)

The materials on this Web site are for your general educational information only. Information you read on this Web site cannot replace the relationship that you have with your health care professional. We do not practice medicine or provide medical services or advice as a part of this Web site. You should always talk to your health care professional for diagnosis and treatment.

  • Published: December 07, 2005
  • Updated: October 14, 2008