Neck Pain Tracker

When you visit the doctor, it can be helpful to have a record of your neck pain. This diary will help you track the frequency and intensity of your pain. And it may reveal a pattern that will help you and your doctor identify a successful treatment plan.

Date

Duration

(Include start time/end time)

Type of Pain

(dull, aching, hot, throbbing)

How painful?

(Rate the pain:
1=mild,
2=moderate,
3=severe)

Possible Causes

(Did something trigger the pain?)

Medication

(What did you take? Did it help?)
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