Pain Flare-up Diary D e v e l o p a s t e p - b y - s t e p p l a n t o u n d e r s t a n d y o u r p a i n ( s o y o u c a n s t a r t t o p r e v e n t i t ) . DEVELOP PAIN CONTROL L O C A L F A C T O R S W H O L E P E R S O N F A C T O R S Joint structure health: Nerve, bone, cartilage, muscle ,joint Avoiding or moving in a protective way/unable to relax in an unvaried, provoking way Moving Moving too much/moving too little Reduced leg fitness Overall Health: Obesity, diabetes, heart disease, lung disease, osteoporosis, mental health, medications How we Feel: Fear or moving, frustration, anxiety, anger, low mood What we think: Our confidence, what we've been told, how often we think about pain Lifestyle: Poor sleep, low physical activity, smoking, ect Impact on life: Isolation, unable to do the things we love to do, work pressure, home trouble M a y C o n t r i b u t e t o J o i n t s B a c k T i s s u e s Why keep a Pain Flare-up Diary? The most useful tool for someone living with osteoarthritis is the flare-up diary. The diary keeps a record of pain episodes, how often you have them, is treatment working and triggers. In three months, you will not remember everything - start detailing your pain episodes to prevent them happening! A flare-up diary is very helpful to plan the right treatment for you. With a diary, we can evaluate the situation at a glance. To treat cholesterol, blood samples are necessary. To treat diabetes, blood sugar is monitored regularly. Migraines are tracked. To treat osteoarthritis, a diary is required! A few good reasons Learn to control your pain To identify triggers for the future Recognize warning signs Track your progress and improvement As a record for you healthcare team T R I G G E R S & I N F L U E N C E R S Strain/sprain Sudden increase or decrease in physical activity/exercise Stressful experiences e.g. work pressure, family strain Poor sleep Poor general health or acute illness like the flu Life stages Osteoarthritis pain is influenced by a number of factors. These will be different for each person but may include physical aspects, general health and lifestyle. How we think and feel about our joints is also important as it can change how we move and perform activities such as bending, walking and lifting. M a y C o n t r i b u t e t o J o i n t s B a c k T i s s u e s too much activity too soon Suddenly some changes happen in this persons life, filling the cup more! Anxiety worry Poor sleep Joint changes Diabetes Inflammation Joint chemicals Anxiety Joint chemicals Pain is Multidimensional As pain persists it becomes less about tissue damage and more about anything in your life or that can make your tissues more sensitive. Pain is normal but what happens when it persists is that we get better at it - in a sense, we have an overprotective pain system . It's easier for the pain to be “triggered’ and multiple things in our lives can contribute to this. It's not just about muscles, tendons, cartilage and joints. It's everything in our lives. For example, big tough football players are more likely to get injured when they have a lot of physical/ mechanical stress. That is what most people would expect. But they are also more likely to get injured when they have a lot of school stress Look at pain as the overflowing of a cup . Many things contribute to what is in that cup. You can have a lot of physical, emotional and social stress and have no pain . But at some point a sudden increase in one of those stressors or a new stressor puts you just over the edge and the water flows out and now you have pain. Often people will have more pain when there are changes in the stressors in their life Pain occurs when we fail to tolerate and adapt to all the stressors in our life. It's not stress - its unmanageable stress We need to keep that cup from overflowing. worry Joint chemicals Lack of activity Poor sleep too much too soon History of pain Fear Joint changes Diabetes Example of someones cup NOT overflowing! Here they don't have pain! Inflammation Childhood Trauma Cardiovascular disease Anxiety The The Cup Analogy Cup Analogy Lack of activity too much activity too soon History of pain Fear Childhood Trauma Cardiovascular disease Let's find what's filling your cup & start a diary! Cup Overflows Pain Happens New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ? New Pain Episode L i s t a l l n e w U N A C C U S T O M E D p h y s i c a l a c t i v i t i e s i n l a s t 2 w e e k s ? ( n e w e x e r c i s e , c h o r e s , y a r d w o r k e c t . ) R A T E Y O U R S L E E P Q U A L I T Y I N L A S T 2 W E E K S N E W F O O D S / M E D S / T R E A T S ? N E W M E N T A L S T R E S S O R S R E C E N T L Y Date : W o r s t q u a l i t y s l e e p B e s t q u a l i t y s l e e p 0 1 0 5 D O I H A V E W O R K - L I F E B A L A N C E ? N o Y e s D e t a i l s : H A V E I B E E N E N G A G I N G I N H E A L T H Y S O C I A L A C T I V I T I E S R E C E N T L Y ? N o Y e s D e t a i l s : A R E M Y O T H E R H E A L T H C O N D I T I O N S U N D E R C O N T R O L ? N o Y e s D e t a i l s : H A V E I B E E N P A R T I C I P A T I N G I N M Y U S U A L E X E R C I S E H A B I T S ? N o Y e s D e t a i l s : W H Y D O I T H I N K I ' M H A V I N G T H I S E P I S O D E ?