Daily Arthritis Symptom and Management Tracker

A comprehensive tool for monitoring arthritis symptoms and treatment effectiveness

Orthopedics

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: ___________________ Date Range: //___ to //___

Daily Pain Assessment

Rate your pain level (0-10, where 0 = no pain, 10 = worst pain)

Date AM Pain PM Pain Location Triggers

Medication Log

Date Medication Dose Time Taken Side Effects

Physical Activity Record

  • Type of exercise: ________________
  • Duration: _______ minutes
  • Intensity (circle): Low / Moderate / High
  • Pain before exercise (0-10): ___
  • Pain after exercise (0-10): ___

Joint Stiffness

  • Morning stiffness duration: ___ minutes/hours
  • Weather conditions: ________________
  • Stiffness triggers: ________________

Daily Function Impact

Check activities that were difficult today: □ Dressing □ Bathing □ Walking □ Climbing stairs □ Gripping objects □ Writing □ Other: ________________

Notes

Mood/Stress Level: ________________ Diet Changes: ________________ Other Observations: ________________

Weekly Summary

Overall Progress: ________________ Questions for Doctor: ________________

Bring this tracker to your next appointment Doctor's Name: ________________ Next Appointment: //___

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