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Keeping a Pain Diary
- How extensive should your diary be?
- Brevity is usually best in a diary. There are a few reasons for this:
- During your recovery period, you will likely want to spend as little time as possible focusing on your pain and disability;
- You will eventually need to read your diary in preparation for answering questions under oath. If your diary is too extensive, you will likely have difficulty remembering what you wrote;
- If you have a large diary, it will take you many hours to read and summarize the essence of your diary regarding your condition during each month or season. (No one in the legal system is interested in a daily or weekly account of your problems);
You may find it best to sit down at the same time every week or second week and spend 10 minutes or so summarizing the past week or two. In this summary, you could describe five things:
- your pattern of pain,
- your sleep interference,
- whom you saw for treatment and when,
- the activities you tried and the result, and
- the amount of time you spent doing active rehabilitation.
The following words are useful when describing your pattern of pain:
- mild pain
- mild to moderate pain
- moderate pain
- moderate to severe pain
- severe pain
- very severe pain
The abbreviations of these words, which you can use in your diary, are: mi, mi-mo, mo, mo-sev, sev and v-sev.
Some people prefer using numbers to describe their pain—10 being the worst pain imaginable, 0 being no pain and 4 to 6 being the mid-point between the two extremes.
Many people have better and worse days. You could write, for example, that you had three better and four worse days during the week, and then describe your pain pattern on an average better day and worse day, i. e. , 'on a better day - sev pain —about 10%, mo to sev—20%; mo— 40%; mi to mo—20%; mi—10%. '. Of course, these would only be your best estimates. No one can be mathematically precise about this.
You could describe your sleep loss by stating:
- the approximate number of hours and fractions of hours it takes you to get to sleep on better and worse days,
- about how often you wake up, and
- about how long you think you are awake per night after first getting to sleep.
For example, on better days,
- 1. 5 hours to get to sleep,
- wake up about 3 to 5 times, and
- awake about 2 hours during the night.
You can use shorthand to record this information.
You could describe your exercise program by stating the approximate number of hours or minutes per day you devote to stretching, strengthening and cardiovascular activity. This information is important to counter the standard ICBC argument that you did not do enough exercise over time and, therefore, your slow recovery is your own fault.
You could describe activities you tried and had trouble with, or activities that later increased your pain.
If you're on a graduated return-to-work program, note the number of hours you worked each day.
Note the dates you sought treatment for your injuries.