Keeping a Pain Diary Might Make Your Pain Worse

Medieval Compiler

Many people who deal with chronic pain are asked by their doctors to keep a diary in which they track the day-to-day severity of the pain they’re experiencing, the idea being that this information can help their doctors manage that pain and treat the underlying conditions. But some past studies have shown that keeping a pain diary could exacerbate symptoms, writes Robert Ferrari of the University of Alberta in a recent article in Rheumatology International, and he wanted to learn more about this possibility.

To do so, he assigned a group of 58 study participants with acute lumbar (or lower back) sprains to one of two groups: Half were instructed to keep a pain diary for four weeks, and half were not. Three months after the study started, 79 percent of patients in the control group reported that they had recovered from their injury, while just 52 percent in the pain-diary group had.

Even though this wasn’t a gigantic study, the finding is still an interesting one, and it does fit into prior research. So what could be going on here? As Ferrari notes, pain isn’t a simple matter of physical processes. Rather, it’s influenced “by numerous factors, such as [a patient’s] current emotional state.” Keeping a pain diary could, among other things, alter that state by causing patients to focus more on their pain than they would have otherwise: As a result, the practice could “increase the perception and recall of a greater frequency and intensity of symptoms.” 

Ferrari thinks the benefits of pain diaries “have not been demonstrated.” If future findings mirror this one, it’s going to be harder and harder to argue with him.