Part of the daily routine for some people suffering from chronic pain is recording their pain in a diary. Many times it is done at the request of a physician or therapist. The patients might be asked to record how severe the pain is, how it affects their daily activities, and which treatments ease the pain, or make it worse.

A new study from the University of Alberta’s Faculty of Medicine & Dentistry shows that well-intentioned diaries may have unintended consequences.

The study, published in the January edition of the journal Rheumatology International, looked at the effect of a daily pain diary on recovery from acute lower back sprain. Half the subjects were asked to keep a pain diary for 4 weeks and given instructions to rate their daily pain on a scale of one to ten. The other half acted as a control group and did not keep diaries.

“What we found is that the group who kept the pain diary – even though we didn’t ask them to keep an extensive diary, and even though many of them didn’t keep a complete diary – had a much worse outcome,” says Robert Ferrari, a clinical professor in the Faculty of Medicine & Dentistry’s Department of Medicine. “The self-reported recovery rates were 52% in the group that kept a pain diary and 79% recovery at 3 months in the group that did not keep a pain diary.”

“That’s a fairly profound effect. There aren’t many things we do to patients in terms of treatment that affect the recovery for a group by 25%.”

Ferrari believes the findings are a clear indication that asking patients to focus too much on symptoms may cause them to amplify them, creating a perception of illness and in turn preventing recovery. He recommends physicians and therapists not ask their patients to keep pain diaries.

“It’s just more evidence suggesting that how we think about our symptoms affects our symptoms. Symptoms are everything when it comes to the sense of recovery,” he said.
March 23, 2015

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