Most pain diaries ask one question: how bad was it, one to ten. For ankylosing spondylitis that single number hides the distinctions a rheumatologist actually needs — where the pain was, whether it was pain or stiffness, and whether it was the spine or another joint.
Three signals, not one
The BASDAI itself keeps these apart: one question for neck, back or hip pain, one for pain or swelling in other joints, and two for morning stiffness (NASS, The Bath Indices). A personal record that mirrors this structure produces numbers that map directly onto the questionnaire, and it lets you see when one moves without the others.
| Signal | Scale | Record alongside |
|---|---|---|
| Spinal pain (neck, back, hips) | 0–10 | Where along the spine, and whether it woke you |
| Other joint pain or swelling | 0–10 | Which joint(s); swelling yes/no |
| Morning stiffness | Severity 0–10 and duration | See the morning stiffness guide |
Using the 0–10 scale consistently
The numerical rating scale has largely replaced the 10-centimetre line in clinics, and NASS notes that people find it quicker and easier (NASS). Its weakness is drift: a 6 in January may not be a 6 in June. Two habits help.
- Anchor the ends once, in writing. What is your 0 and what is your 10? Keep the note and reread it occasionally.
- Rate the day as a whole, or a fixed moment, and be consistent about which. The BASDAI asks about the past week overall; a daily diary usually asks about today.
Location and the body map
Where the pain is often matters more than how much. Pain in the buttocks that alternates sides, pain at the heel or the front of the chest where tendons attach, or a swollen knee are different conversations from lower back pain. Note location every time it changes; a body map — tapping the region rather than describing it — makes this quick. HAVYT’s check-in records pain by body region for this reason.
Pain, stiffness and the night
The NHS describes AS pain as typically worse in the morning and at night and better with exercise rather than rest (NHS). Recording whether pain woke you, and whether it eased with movement, captures the character of the pain as well as its size — which is information a clinician uses. See sleep and ankylosing spondylitis.
Reading it back
Over weeks, chart the three signals separately. Ask whether spinal pain and stiffness are moving together or apart, whether a peripheral joint has become a regular feature, and whether the worst stretches line up with flares you marked. Then look at what sat beside the worst stretches in your record — sleep, load, medication timing — and bring any association to your team as a question. HAVYT’s pattern view is built to make that comparison without asserting a cause.