Keeping a Migraine Diary: The Basics

Keeping a migraine diary gives you vital information that can help track down the patterns of your migraine attacks – when and how often they occur and how long they last, what your symptoms are (before, during and after the most painful phase of the migraine), what your pain levels are, where the pain is located, what meds you take and if they work, what your potential triggers are, and so on. Over the long term, the diary can show you how effective a preventive treatment is for you, whether your abortives are working optimally, and what other symptoms you might need to treat.

Too bad keeping a migraine diary can be a huge drag. Covering all the potential triggers, symptoms, and details requires remember and recording a lot of minutiae, some of it retroactively. Identifying the significant parts can seem impossible. Do you include the weather? Does it matter that you had a glass of wine 22 hours before the migraine hit? What if your pain fluctuates throughout the migraine – do you record the highs or the lows? If you have chronic migraine and can’t tell when one migraine attack stops and another one begins, how do you record the time of onset and duration?

The best way to gather this valuable data without getting overwhelmed is to keep your diary as simple as possible. Below are the basic recommended areas to cover, which I gleaned from the diary that a famous headache clinic uses for it’s research and combined with my own suggestions and those I’ve learned from other migraineurs. Since not all the questions will apply to everyone, I’ve listed it out in narrative form. Once you decide which questions to include in your own diary, the format is up to you. Maybe you print out list of questions, create a simple spreadsheet, jot down your answers on your daily calendar, or keep track in your phone’s notes app. Again, it’s all about finding the method that you’re most likely to keep up with. It doesn’t have be fancy, you just have to use it.

Time/Duration
What time did the migraine begin? How long until you were entirely pain-free? (This won’t apply to some chronic migraineurs – jump straight to the severity questions, which also record duration.)

Severity
How painful was the migraine at it’s most severe? How long did the severe pain last? What was the average pain of the migraine? (As a chronic migraineur, I find it helpful to record my daily low and high pain levels and the duration of each.) Many people find a 0-10 scale the best way to record pain levels, others rate it on a scale of mild-moderate-severe, still others assign colors (either green, yellow, and red like a traffic light or their own colorful scale).

Symptoms
What are the top three most bothersome symptoms? You can list more and can even rank them, but be sure to get the basics down.

Medication
What abortive medications or painkillers did you take and what was the dose? Record either the time you took them or approximately how far into the migraine symptoms you were before medicating.

Quality of Life Impact
Using the green, yellow, and red traffic light system to record how your life was affected during a migraine is a very easy way to capture a huge amount of information. This one isn’t strictly necessary, but communicates the burden of migraine to your doctor succinctly and powerfully.

That’s it for the most important questions. That’s right, you can get the most important data by answering those few questions. Sure, it can be helpful to provide more information, but if you can only deal with the basics, then having those few details is better than none at all.

P.S. Don’t want an at-a-glance record of your life’s most painful moments? Write down the basics on a note card. You can flip the card over and never look at it again, but at least you have the data and can show it to your doctor. For many years, I refused to keep a diary because without it, I could pretend like I wasn’t as sick as I really was. Hiding from the truth only made it more difficult to get good medical care and figure out if preventive medications were working for me. The 3×5 card method was a step forward in my care.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (4)
  • Sandy
    4 years ago

    oh my gosh thank you for this article. ihave just found this article. i too did not do headache diary for years i guess for denial. now, i am at the point of have to to help my drs know what works and for futher reference for disability as i am concerned may not b able to work again at least not right now. did not know how to record migraine bc they are now chronic and may start off at a mild level in the morning 3 but move up to 6 or 7 by the end of the day. sometimes go away in 7 or 9 hrs sometimes not at all. triggers? how do you id triggers when it is a 4 day migraine. continuation maybe? i spoke with my dr. i will be using the MIDAS scale to determine the impact of disability migraine has on my life. easier for him and has data and scoreability. thanks kerry

  • Ron
    5 years ago

    If you use an iPad, iPhone or an Android device I found a great program for tracking and analyzing your migraine’s. The name of the program is Chronic Pain Tracker by Chronic Stimulation, LLC. I found it in Apple’s AppStore for $9.99.

    The app makes it possible to track a lot of information and see it in detailed reports. The analysis reports can give you insight into what may be triggering the onset of your pain or what may be elevating your symptoms.

    I use Chronic Pain Tracker every day to track my chronic daily migraines. Every morning and every afternoon I post a diary entry. Each entry only takes a minute or so to complete. Besides tracking your migraine pain, triggers, symptoms, etc. the program can also track your blood pressure, your weight, your medication use and much more, it’s amazing.

    This app with its fantastic reports helped me identify even complex migraine triggers. One trigger I never before identified was the fall of barometric pressure. Every time a weather front would approach I would feel worse, I didn’t realize it was because the barometric pressure was in the process of falling.

    The latest update is FANTASTIC. They added more trackers like sleep, mood, etc. They also added Dropbox synchronization, now all my devices are in sync automatically!

    The app is something you never want to be with out if you’re suffering from a chronic condition and require detailed analysis using a wide variety of tracking options.

    Ron

  • lara
    5 years ago

    Something to consider as well, years ago when I had to file for private disability insurance, the company asked me to produce a headache diary going back 6 months to prove the severity and frequency of my migraines.

    Even though the diary was completely subjective? The diary was the proof that put case over the top and allowed the payout which I needed because I had been out of work for months at that point.

    At this point, though, I haven’t kept a diary in years because: hassle.

    However, with the issues I’m currently having regarding SSI and state disability, I am reconsidering. It is, perhaps, the best documentation regarding attacks and it’s a good indication of when and how the attacks occur AND it indicates “why” you can’t provide an employer with a stable work schedule and why you “can’t” predict migraine attacks.

    I’d like to see the best data scientist come up with model to accurate predict migraines based on weather triggers, hormonal triggers, scent, smell, food additives et al 🙂 Good luck, buddy

  • Bruno Godbout
    5 years ago

    Thank you for the excellent tips Kerrie. I thought the 3×5 card method particularly insightful. This will influence the design of the app I am working on.

  • Poll