Free template · Print or save as PDF
A row of pain scores tells you some days were worse. This diary records what else was true on those days, so the numbers have something to sit next to when you read them back.
It follows the pain diary guide, including the advice to anchor your scale once and rate the same thing every day.
Published
| Day | Pain (0–10) | Where | Stiffness (0–10) | Sleep (h / quality) | Energy (0–10) | Mood (0–10) | Activity | Medication changes | Note |
|---|---|---|---|---|---|---|---|---|---|
| 1 | |||||||||
| 2 | |||||||||
| 3 | |||||||||
| 4 | |||||||||
| 5 | |||||||||
| 6 | |||||||||
| 7 |
This template is for recording, not for diagnosis or treatment decisions. Bring it to your clinician; do not change medication on the basis of what it shows.
HAVYT’s daily check-in records the columns above — stiffness, pain by region, fatigue, sleep, flare, medication, activity — in under a minute, charts them over time, and turns any period into a report for an appointment. Free to start on iPhone.