5 Things to Track in Your Migraine Diary

If you find yourself facing an increasing number of migraine attacks, or difficult symptoms to navigate, you may want to start a migraine diary. Here’s what I track in my diary.

Managing migraine can be challenging. Still, there is no simple test or scan that can determine the severity of migraine.

So much of how doctors diagnose and treat migraine is based on the information we tell them about our symptoms and history.

A migraine diary is one of the simplest ways to keep track of your migraine patterns and effectively communicate the nature of your attacks and symptoms to your doctor.

Not only do migraine diaries help provide a clear picture of your unique experiences with migraine, but they can also help you and your doctor spot potential patterns that might be happening and gauge whether your current treatment plan is working the way it should be.

Migraine diaries are personal, and it’s important to find a format for yours that works for you. Focus on finding a format that you will be able to stay consistent with.

I found that when starting my migraine diary, it was important to keep things as easy as possible. I made sure I had a format I could fill out in just a minute or so at the end of each day.

The last thing most of us feel like doing after a migraine attack is writing down a lot of information before bed. There are several migraine diary templates online, as well as different apps you can use. I have always loved just keeping a simple diary in a notepad.

It’s a great idea to ask your doctor if there are specific symptoms, behaviors, or lifestyle factors that they think you should track in your own journal. Here are the five things I record in mine to help you get started.

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Migraine attack days

I record an “X” on any day when I have a migraine attack.

This makes it easy to quickly count my total attack days at the end of each month. When you see a headache specialist, one of the first questions they ask is how frequently your attacks occur.

Having a simple method to record attack days makes this question easy to answer.

Average pain score

When my migraine attacks were chronic, I had daily head pain alongside my migraine episodes. I found it helpful to record an average pain score each day to observe how my general head pain changed day-to-day as well as during active migraine attacks.

I used a 1–10 pain scale and made notes about what the different numbers on the scale meant for me so I could stay consistent. Pain scales are subjective — for example, my “6” might be someone else’s “10.”

I explained to my doctor, my family, and certain friends what various numbers mean for me. By tracking my average pain levels every day I learned that my baseline daily head pain was somewhere between a 5 and 6, but my pain would go up to a 7–9 during migraine attacks.

A low pain day for me would be around a 4. Before bed, every night I would reflect on the day and record an average pain score for the day.

Average activity score

As useful as pain scores are, they don’t necessarily capture the full burden of disability I experience living with migraine. My headache specialist nurse recommended that in addition to an average pain score, I also keep an average activity score each day.

I used a 1-5 scale for activity and again, made sure that both my doctor and the people closest to me understood what different numbers on this scale meant for me.

For example, a 1 would be a bad migraine attack day where I spent all day in bed, whereas a 3 might be going out for an appointment in the morning and a short walk followed by a rest in the afternoon and being able to watch some TV in the evening.

Recording an activity score is a great way to communicate the holistic effect migraine has on your life to your doctor.

Acute medication

When I go through periods when it’s difficult to manage my migraine attacks, I find it easy to fall into the trap of taking increasing amounts of acute medication.

Recording any acute medication you take in your migraine diary, is a great way of staying on top of how many days of the month you are taking acute medication.

Monitoring how many days of the month you take medication is important so that you can avoid getting overuse, or rebound migraine attacks. I recommend jotting down the name of the medication, the dose you took, and how many times you took it on any given day.

Again, this makes it easy at the end of the month to quickly tally how many days you took acute medication. It can feel scary to see how often we are relying on acute medication.

Still, it’s so important to track your use of medication so that you and your doctor have a clear understanding of how to adjust your treatment plan.

Triggers and patterns

The final thing I would recommend recording in your migraine diary is any triggers or patterns you notice. Don’t worry if no specific trends stand out to you right away.

Keep jotting down notes about anything out of the ordinary you ate or did before an attack, then you can look back on past weeks, and months, of notes and start to see patterns emerge.

I was able to start to pick up on patterns between changes in my routine and the effects these changes had on my attack days.

The bottom line

Finding a treatment plan to manage your migraine attacks can feel challenging and frustrating.

Keeping a migraine diary can help you stay on the same page as your doctor and make sure you both have the information you need to create an informed, and effective, treatment plan.