Two people walk into the same clinic having both logged a daily number for three months. Both series average around six. One of them is describing a joint that hurts when it is loaded and settles when it is rested. The other is describing a burning band down one leg that is worst at night and is accompanied by numbness. The numbers are identical. The problems are not.
That gap is the whole subject of this page. Tracking intensity is easy, cheap and habit-forming, which is why almost every pain app is built around it. Tracking the features that tell a clinician what kind of pain they are looking at is harder to make into a daily habit, and it is the part that changes what happens in the appointment.
What each one actually is
Pain tracking is the intensity record. A number, a date, maybe a site. Its strength is that it is fast, repeatable and comparable to itself over time, so a clinician can look at four months of it and see a direction. Its weakness is that the number is a private unit. Your seven is not somebody else's seven, and after a few months of living with something it is often not your own seven from last year either. People habituate, and the series quietly drifts down while nothing has improved.
Mechanism tracking is the descriptive record: the observations a clinician uses to work out what is generating the pain. Where it sits and whether it spreads. What it feels like in your own words. What sets it off, and what settles it. How long an episode lasts. What comes with it. What happened when you tried something. None of those items is a diagnosis. Together they are the raw material a diagnosis is made from.
Clinicians reason in broad categories here, and you will hear the words: pain coming from tissue damage or inflammation, pain coming from a nerve, and pain where the nervous system itself has become over-responsive. Which category applies, or whether more than one does, is decided by a person who can examine you. It is not decided by an app, and it is not decided by you at home.
Why your own record should not name a mechanism
This is the one piece of advice on this page that is worth more than the rest of it combined. Record observations. Do not record conclusions.
There are two reasons. The first is that a self-assigned label is often wrong, and a wrong label in a document you hand to a clinician costs you time you came there to spend on something else. The second is subtler and does more damage: once you have written "nerve pain" into your own diary, every subsequent entry gets filtered through it. You start noticing and logging what fits and skipping what does not. Six months later the record looks like beautiful confirming evidence and it is really just the first guess, repeated.
The same applies to causes. Write down that you slept badly, that the weather turned, that you did the long walk, that a dose was missed. Write them as dated facts. Deciding which of them matters is something you and your clinician do later, looking at months of entries together.
The short version of the descriptive half
Five items. A line each. They are not a questionnaire, and a day where you only fill in two is still a useful day.
1. Where, and whether it travels
Name every site, not only the worst one. When you are asked where it hurts, you answer with whatever is loudest, and the other three go unmentioned. Over months that habit turns a widespread problem into a local one on paper. Note it too if the pain runs somewhere, for example down the back of a leg or into a hand, and where it starts and stops.
2. What it feels like, in your words
Aching, throbbing, burning, shooting, electric, crushing, stiff, raw, heavy. Pick the words you would actually use rather than the ones that sound clinical. Quality words carry information that a number cannot, and they are the part of the record a clinician will read first.
3. What provoked it and what settled it
Movement, load, sitting still, cold, touch, pressure from clothing, a particular activity, the hours after that activity. And on the other side: rest, heat, movement, position, a medication, time. Pain that is worse with use and better with rest behaves differently from pain that is worse at rest and eases once you get going, and that difference is visible only if you wrote it down.
4. What came with it
Numbness, pins and needles, weakness, swelling, redness, heat, morning stiffness and roughly how long it took to loosen, fatigue, disturbed sleep, delayed payback a day or two after activity. These accompanying features are often the most informative single line in the entry.
5. What you tried and what happened
The medication, dose and timing, or the heat pack, or the stretch, and what the pain did afterwards and how long the effect lasted. Response to treatment is evidence in its own right, and "it did nothing" is as useful a line as "it helped for two hours".
How to carry both without giving up in week three
Keep the cheap half daily and the expensive half occasional.
The number takes seconds and its value comes from being unbroken, so log it every day even on ordinary ones. The descriptive entry earns its place only on days that were different: a flare, a new site, a new sensation, the first week of a treatment change, or a day something you do regularly suddenly cost you more than usual. Three or four described days a month, written on the day, beat a paragraph a day that stops in October.
And write the description close to the event. A flare feels unforgettable while it is happening and is largely gone within a week; what survives is skewed toward the worst moment and the most recent one. The hour after it eases is when you know more about your own condition than at any other time.
What this looks like in an appointment
The useful handover is one page, and it has two halves. A trend, so nobody has to take your word for the direction of travel. And two or three described episodes with dates, so there is something concrete to examine. That is a very different conversation from being asked how things have been since last time and reconstructing four months out of memory in the ten seconds before you answer.
It is also a shorter conversation, which matters, because the descriptive half is exactly what gets skipped when an appointment runs out of time.
Where Pain Journal fits, and we built it so we will say so plainly
Pain Journal is our own app, and it is built around this split. The daily entry is a score and a body map, which is the fast half: you tap every region that was involved rather than naming only the peak. Pain type, what set it off, sleep, medications and a free note are there for the days that need the descriptive half, and they are optional on the days that do not.
A few entries a week become a PDF for the appointment, with the summary on the first page. That report is free and stays free: the last 7 days, no credits, no fee per export, which is the main way we differ from the paid-report apps. Everything stays on your device, there is no account, and it works offline. There is also a free printable pain diary if you would rather use paper, and it asks for the same things.
Whichever you use, the rule is the same one this page opened with: record the observation, let the clinician draw the conclusion.
Common questions
What is the difference between pain tracking and mechanism tracking?
Pain tracking records how much it hurt and when, usually as a number over time. Mechanism tracking
records the descriptive features a clinician uses to work out what kind of pain is driving it: where it
sits, what it feels like, what provokes and relieves it, what it is accompanied by, and how it responds
to what you have tried. Scores give trend. Descriptive features give a clinician something to reason
from.
Should I try to work out my own pain mechanism?
No. Classifying pain is a clinical judgement made from an examination, your history and sometimes
tests, and it can change over time. Your job in the record is the observation, not the conclusion.
Writing a mechanism into your own notes early tends to stick, and everything recorded afterwards gets
bent to fit it.
Is a 0-10 pain scale useless then?
Not useless, just narrow. A score series is good at one thing, showing whether the overall level is
moving across weeks and months, and it is quick enough that people keep doing it. What it cannot do is
distinguish two very different problems that both got scored a seven. The fix is not to abandon the
number, it is to record two or three descriptive facts beside it.
What descriptive details are worth recording?
Location and whether it spreads, the words you would use for how it feels, what brought it on and what
settled it, how long it lasted, what else came with it such as numbness, tingling, stiffness on waking,
swelling or payback after activity, and what you took or tried and what happened next. A line each is
enough.
How do I keep this short enough to actually do?
Keep the score daily and the description occasional. A number takes seconds and can be logged every
day. The descriptive entry only earns its place on days that were different: a flare, a new site, a new
sensation, or the first days of a treatment change. Three or four described days a month is far more
useful than a paragraph a day you abandon in week three.
This guide is about keeping a record, not about treatment or diagnosis. Pain Journal is a personal pain diary and not a medical device, and nothing here is medical advice. What your pattern means, and what to do about it, belongs with your own clinician.
