Is tracking your pain a mistake?

Health.com had an article on 13 mistakes that Fibromyalgia patients make; the first mistake was “not tracking your pain”. They suggest that you should keep a pain diary to be able to better assess improvements in your health. Since “patients are always in pain so it’s hard to judge when things get better “. I don’t know about you but I can tell when I’m doing better, I can also tell when I’m doing worse. My feeling here is that it may be a bigger mistake to keep a pain journal for the simple reason that it forces you to focus on your pain. When you focus on your pain (instead of on other things) you feel it more, this has not only been shown in multiple studies but I’m pretty sure that most pain patients would agree as well. When I’m at my worst it’s hard not to focus on my pain, it’s hard to distract myself from it. However, when things are moderate or less I can easily distract myself and often not even think about the pain I’m in; yet, when I sit down to try to keep a pain journal I force myself to think about what hurts.

Here’s the deal, I always hurt, my head always hurts; however, I don’t always think about it. Most of the time I can focus on other things and distract myself. This is difficult for most people with acute random migraines to grasp; their knowledge of a migraine is something that hits occasionally and when it does it knocks them out. So, the idea that I can stand upright, have a conversation with you, and possibly even smile through the kind of pain they are imagining (and the kind of pain I am experiencing) blows their mind. Often, they think I must be lying; but, after three months straight of the worst chronic migraines I’ve ever experienced, everything else seems a little less, a little easier to work through. So, I don’t journal my pain. I do keep a migraine diary; however, I only log the times when it gets bad enough that I have to take medication of some kind (this ranges from 6 times a month on a good month, to every other day or more).

Continuing through the list of mistakes we evidently make, the second mistake is “expecting too much from medication.” I’m not sure what we are supposed to expect (according to the article) but I’m pretty sure all that any of us expect is that they will provide more benefit than detriment, something that rarely happens. Saying that we should be flexible and willing to try other options seems naive, considering most Fibro patients that I know who are willing to try anything and jump through any hoop to feel better. However, when the three main medications on the market have effectiveness rates of 60% or lower in studies that don’t even take into account co-morbid conditions or other medications the patient might be on, seems to me that pharmaceutical companies aren’t expecting enough.

Number 3 on the list “refusing to consider off-label drugs” is another one that I’ve never encountered. Most Fibro patients start with off-label prescriptions like antidepressants and muscle relaxers before any doctor ever prescribes the big 3 approved medications. The list continues from there with items that I would agree with on every front, things like “sticking with a doctor for too long”, “not reaching out to others” and “feeling guilty” (something that I talked about here).

Take a look through the list, are there any that you disagree with? How do you feel about tracking your pain? Has it helped you? Is it something you feel hurts you?