Daily Pain Flare-up Monitoring Chart Daily Pain Flare-up Monitoring Chart Date and Time: Pain Level (0-10): Pain Areas: Lower Back Neck Chest Abdomen Pelvis Right Shoulder Right Arm Right Forearm Right Wrist Right Fingers Right Hip Right Thigh Right Leg Right Foot Right Toes Right side of Body Left Shoulder Left Arm Left Forearm Left Wrist Left Fingers left Hip Left Thigh Left Leg Left Foot Left Toes Left Side of the Body Head Upper Jaw Lower Jaw Right Side of the Face Left Side of the Face Whole Body Pain Pattern: Old Pain New Pain Both Old and New Pain Red Flags: Weight Loss Fever Loss of Organ Function Breathlessness Injuries like Fractures None Pain Triggers: Quick Log: Medications/Treatments Used: Side Effects: Download PDF Save Data Share via Email Share via WhatsApp
