Burning Nights CRPS Support is a UK national charity dedicated to raising awareness of Complex Regional Pain Syndrome (CRPS)
Pain Diary Template For CRPS


Writing in a Pain Diary is so helpful on many levels

Writing in a Pain Diary is so helpful on many levels



The Burning Nights CRPS Support Pain Diary for CRPS template is available for you to download, print or use on your computer.


It has been produced as a PDF document, so please click -> Burning Nights CRPS Support Pain Diary 2017 to take you straight to the template. Please feel free to download and print it out or even forward it to a friend. You can always download the Pain Diary and fill it in on your computer if you prefer.  If you already have ADOBE Reader then it should be editable to you, however if you don’t have Adobe Reader then click on this -> LINK to download it free.


Pain Diary for CRPS - Burning Nights CRPS Support

Pain Diary for CRPS – Burning Nights CRPS Support


If you keep a Pain Diary for chronic pain or CRPS it serves a number of purposes. One of the most important purposes is to help you accept your chronic pain or Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy. Acceptance is a huge part of your coping strategies for having a chronic condition like CRPS. It can take weeks, months or even years to actually learn to accept you have chronic pain and it is a part of you. (Cho, S. et al. 2012) When you are taking a lot of pain medication and you are in constant pain it can become hard for your to think clearly or see any pattern that is emerging etc.



Burning Pain | Pain diary template for CRPS

Burning Pain

By using the Burning Nights Pain Diary template you can keep a good track of your pain by documenting certain areas of your chronic persistent pain such as:

  • Where in your body was the pain, where did the pain start or where was the worst pain

  • Intensity of the pain

  • Description of the pain – was it sharp, pricking, burning, tingling

  • What were you doing at the time

  • How do you actually feel – are you upset, tired, depressed, stressed

  • How long did the pain last before medication kicked into your system or before the pain started to ease

  • Medication you took

  • Other strategies you used to help calm the pain down – breathing, mindfulness, mirror therapy, distraction techniques


[Tweet theme=”basic-full”]Download the Burning Nights #CRPS Support #ChronicPain diary, by visiting their website www.burningnightscrps.org/pain-diary-template/[/Tweet]

You will also find the Burning Nights version of the chronic pain pain scale, 3 small images of the body for you to draw a circle or line to point out where the pain problem is, as well as additional notes to help you to fill in the Pain Diary and finally there’s an open table for you to add any extra notes you may have.

Pain Scale | Pain Diary Template for CRPS

Pain Scale | Pain Diary Template for CRPS

Using a Pain Diary can be a very useful tool for your doctor to look at, so he/she can see any recurring pattern that may exist. When going to see the doctor, why not take your filled in and used Pain Diary with you and show them. The doctor then will be able to make an informed decision about medication changes, extra advice or support that you may need either physically, emotionally or psychologically and even evaluate any new problems that may be emerging.

There are numerous Pain Apps on the market at the moment and each have different things to offer. Some are free downloads and others you have to pay for. Have a look around first before committing to download one particular app. However in the meantime have a look at our paper version of a Pain Diary.

We do hope you use the Pain Diary Template and if you have any questions or any more suggestions then please do get in touch with us using any of the channels available – email, Social Media or Contact Form




 Last Updated: 30/05/2017

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About the Author
I'm a barrister, advocate & sufferer of Complex Regional Pain Syndrome (CRPS). I am also a bilateral (double) above knee amputee due to aggressive symptoms of CRPS. However I want to help all those affected by this devastating condition which includes those living with CRPS, their loved ones, families, carers and friends. Please help spread awareness of this debilitating and life-changing condition - CRPS. We need your support!
  1. Kat Smith Reply

    I’m wondering if there is a way to develop an app for this. It would be amazingly convenient. Always on hand and easily shared with our physicians.
    Just a thought.

    • Victoria Abbott-Fleming Reply

      Hi Kat,
      We are looking at developing an app using our pain diary as a template. However the cost is quite high for creating an app but it is something that we are most certainly looking into.
      Thanks for your comment though Kat!

  2. Vera Krull Reply

    App would be better vera

    • Victoria Abbott-Fleming Reply

      Hi Vera
      Thank you for your comment. Unfortunately the cost of creating an app in the style we want is extremely expensive & therefore prohibitive. However it is something we would love to do.
      Best Wishes
      Victoria & team

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