The Headache Diary: Why Keeping a Journal Helps

If you’re a migraine sufferer that is asked by a doctor to remember what makes your head hurt, then consider this: For thousands of you, remembering the pain may be the key to effectively treating it. To date, most research and treatment is based on self reports that use information from patients’ daily journals to assess the frequency and severity of headaches. It turns out that memory can play tricks on you, as a recent study from the American Headache Society (AHS) found that the pain of a headache was actually exaggerated in later patient questionnaires than in daily journals.

There are currently no objective tests to track migraines, so accurate self-reporting is critical. The AHS study compared information on the frequency and severity of headaches among migraine sufferers. Daily journals were compared to one-time interval questionnaires taken four weeks before follow-up visits for treatment. The study found that there was no major discrepancy in the reported frequency of migraines, but the intensity was recorded as more severe in interval questionnaires than in daily journals.

The study involved data from 209 patients aged 13 to 78 who completed both methods of self-reporting. There were 177 female and 32 male patients including chronic sufferers (15 or more migraines per month) and episodic sufferers (fewer than 15 migraines per month). This pool of patients is a strong representative sample that parallels data from the Centers for Disease Control showing migraines disproportionately affect females and occur in people ranging in age from 18 to 75.  Researchers compared information from both types of self reports to create a statistical analysis.

The result was that the number of headaches reported in daily journals versus interval questionnaires only differed by half a day, which is considered clinically insignificant. However, migraines were reported as more severe in interval questionnaires than in daily reporting. The severity of pain was measured on a scale from zero to three with three being the most severe and patients reported an average level of 1.63 in their daily journals and 1.84 in the questionnaire. This difference could potentially be attributed to the more subjective nature of assessing the severity of pain versus the existence or occurrence.

Success in migraine treatment is measured as cutting the number of headaches in half and reducing the severity by at least two points, therefore measuring success relies on diligence in patient reports. Accurate self-reporting of migraines is important because the information will not only be used to measure how well treatment is working, but guide patient care when treatment fails.

If you want to log your own headaches, or download an app for your smart phone that allows you to track on the go. Keeping a journal of your headaches may be key to keeping your pain in check.

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1 Comment

  • Your online headache log link is not what I was expecting.
    If you want to have a simple migraine journal, you can try
    Disclaimer: I’m one of the owners and we are looking for beta testers.

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