Pain and addiction are deeply intertwined. Chronic pain is one of the most common relapse triggers, and people in recovery often face unique challenges in pain management, including stigma from healthcare providers and uncertainty about which treatments are safe. This tracker lets you log daily pain levels with context (location, type, mood, triggers), visualise patterns over time, and print a report to share with your healthcare team to support safe, informed pain management decisions.
📝 Log Today's Pain
Select your current pain level, add optional context, and save. Log as often as needed, multiple entries per day are valid and useful for identifying patterns.
Your pain log is stored in your browser session only. Use the Print Report button in the History tab to generate a printable record for your healthcare team, or note significant entries in your Recovery Journal.
Recent entries
📊 Pain history & trends
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Entries logged
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Average score
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Highest score
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Lowest score
Pain trend, last 14 entries (oldest → newest)
Full log (all entries)
Sharing with your healthcare team: Print this page (Ctrl+P or ⌘P) to generate a pain log report. Your pain data, particularly patterns, highest scores, and what makes pain better or worse, gives your prescriber much more to work with than a verbal description in a brief appointment. A printed log also demonstrates engagement in your own care, which can be especially helpful for people in recovery who sometimes experience stigma in clinical settings.
📋 Understanding the pain scale
The 0–10 Numeric Pain Rating Scale is the most widely used pain assessment tool in clinical settings. Understanding what each level represents helps you log consistently and communicate more effectively with your healthcare team.
0
No Pain
Completely pain-free. Full activity possible without any pain awareness.
Log this, tracking pain-free days is as important as tracking pain days. Patterns of pain-free periods are diagnostically useful.
1–3
Mild Pain
Noticeable discomfort that does not significantly interfere with daily activities. Can be ignored most of the time. May occasionally distract from focused work.
Usually manageable with non-pharmacological approaches: heat/cold, gentle movement, distraction, rest. Note what helps at this level.
4–6
Moderate Pain
Interferes with some daily activities and concentration. At 5–6, difficult to ignore for extended periods. Sleep may be affected. Mood typically impacted.
Discuss management strategies with your healthcare team. If this is your typical baseline, document carefully, sustained moderate pain warrants a treatment plan review. Note its impact on mood and cravings.
7–9
Severe Pain
Significantly limits or prevents normal activity. Sleep severely affected. Difficulty concentrating on anything other than the pain. High relapse risk, contact your support network and healthcare team.
Do not manage this alone. Contact your prescribing physician if unmanaged severe pain is recurring. Contact your sponsor, counsellor, or support network, severe pain is a high-risk state for relapse. Use your crisis plan.
10
Worst Possible Pain
Completely disabling, unable to communicate clearly, bedridden. This level is rare but represents a medical emergency context.
Seek emergency medical care. Call 911 or go to an emergency room. This is a medical emergency regardless of your recovery status.
Pain scale consistency: The 0–10 scale is subjective, your 7 is your 7, not a universal standard. What matters for tracking purposes is consistency within your own logs. Score based on how the pain affects your ability to function, not on how you think you "should" rate it. Underrating pain because of stigma (fear of being seen as drug-seeking) or overrating it out of desperation prevents your healthcare team from making accurate assessments.
💡 Pain management in recovery
Managing pain while in recovery from addiction requires careful, collaborative, and transparent healthcare. These principles support safe and effective pain management.
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Always discuss pain management with your healthcare team. The information below is educational, not medical advice. Pain management in addiction recovery is an individual clinical decision that must be made with qualified providers who know your full history.
Be completely transparent with all providers
The single most important factor in safe pain management in recovery is full transparency between all your healthcare providers. Your pain specialist, addiction medicine provider, prescribing physician, and pharmacist should all know about your recovery status and your current medications. Transparency allows for coordinated care, it does not prevent you from receiving adequate pain treatment, and it prevents dangerous interactions or duplications.
Non-opioid treatments first
Effective non-opioid pain management options include: NSAIDs (ibuprofen, naproxen) for inflammatory pain; topical treatments (lidocaine, diclofenac gel); antidepressants (duloxetine, amitriptyline) for neuropathic pain; anticonvulsants (gabapentin, pregabalin); physical therapy and graded exercise; TENS (transcutaneous electrical nerve stimulation); cognitive behavioural therapy for pain; mindfulness-based stress reduction (MBSR), which has strong evidence for chronic pain; acupuncture; and nerve blocks for specific pain types. Many people in recovery find that a comprehensive non-opioid approach manages pain more effectively than single-drug treatment.
Pain is a significant relapse risk, don't ignore it
Untreated or undertreated pain is consistently identified as one of the strongest relapse triggers. The fear that seeking pain treatment will lead to relapse, or that healthcare providers will refuse to treat pain in someone with an addiction history, leads many people to suffer unnecessarily. Both extremes are dangerous: under-treatment increases relapse risk, while unsafe opioid use is its own risk. The goal is adequate treatment through the safest possible means, determined collaboratively with your providers.
Psychological approaches to pain are not "just mind over matter"
Cognitive behavioural therapy for chronic pain (CBT-P) and mindfulness-based stress reduction (MBSR) have strong randomised controlled trial evidence for reducing pain intensity, disability, and distress, not merely the emotional response to pain, but its perceived severity and impact on daily function. These approaches address the psychological amplification of pain that occurs when pain becomes chronic. For people in recovery who are already working with a therapist, integrating pain management into that work is often highly effective.
If opioids are medically necessary
If opioids are genuinely required for pain management, this does not automatically mean relapse or treatment failure. The following safeguards are important: use the lowest effective dose for the shortest necessary duration; involve your addiction medicine provider or counsellor directly; establish clear prescribing agreements and monitoring; have a trusted person manage the medication supply; and increase contact with your recovery support network during opioid treatment. Discuss with your prescriber whether buprenorphine (Suboxone), which treats both opioid use disorder and has analgesic properties, might be an appropriate option.
Emotional pain can manifest as physical pain
Emotional pain, grief, shame, anxiety, depression, loneliness, frequently manifests as physical symptoms, particularly in people who have used substances to manage emotional states and may have reduced capacity to process emotion directly. When pain scores are consistently high but physical causes are unclear or inadequate to explain them, explore whether emotional pain is contributing. This is not to say the pain isn't real, it is real, but that its treatment may require emotional as well as physical approaches.
Movement and exercise for chronic pain
For many types of chronic pain, back pain, fibromyalgia, arthritis, widespread pain, gentle, progressive physical activity is one of the most evidence-supported treatments available. The instinct to rest and avoid movement often worsens chronic pain over time. Graded activity, starting with whatever is manageable and increasing very gradually, reduces pain sensitisation, improves function, and reduces the depression and anxiety that worsen pain. A physiotherapist can design a graded programme appropriate to your specific pain condition.
Pain and addiction recovery: navigating a complex relationship
The relationship between pain and addiction is complex and bidirectional. Chronic pain is both a risk factor for developing substance use disorder, people often begin opioid use legitimately for pain, and one of the most common and powerful relapse triggers for people in recovery. Neurobiologically, pain and craving share overlapping circuits: both involve increased activity in the amygdala, both are worsened by stress, and both are amplified by the psychological state of feeling out of control. This means that inadequately treated pain in recovery is not just uncomfortable, it is clinically dangerous.
At the same time, people in recovery often face significant barriers to adequate pain management, including stigma from healthcare providers, reluctance to prescribe opioids, and their own fear that accepting pain medication represents a relapse or a failure. Both extremes are problematic. Use this tracker to build an objective record of your pain that supports evidence-based conversations with your healthcare team, conversations that prioritise both adequate pain treatment and your recovery safety. Share the printed report with every provider involved in your care. Use the medication tracker alongside this pain tracker to document any pain treatments you are receiving and their effectiveness.
If you are experiencing severe pain and feel at risk of relapse: Contact your addiction counsellor, sponsor, or recovery support network immediately. Do not manage the combination of severe pain and high craving alone. Severe unmanaged pain is a medical and recovery emergency, both need to be addressed urgently, through appropriate medical channels and through your recovery support system simultaneously.
People also ask about pain management in recovery
Managing chronic pain in recovery requires a multi-modal, collaborative approach: full transparency with all healthcare providers about your recovery status; prioritising evidence-based non-opioid treatments (physical therapy, CBT-P, NSAIDS, topical treatments, MBSR); involving your addiction medicine provider in any pain management decisions; and building a support plan for high-pain days that includes contact with your recovery network, since severe pain significantly increases relapse risk. Untreated pain is itself a relapse risk, the goal is adequate treatment through the safest possible means.
Pain tracking provides objective data that makes healthcare conversations more productive and reduces the stigma that people in recovery sometimes face when reporting pain. It reveals patterns, times, activities, or emotional states that correlate with higher or lower pain, guiding both medical and non-medical management strategies. It distinguishes physical from emotional pain. It monitors treatment effectiveness over time. And it demonstrates engagement in your own care, which can be particularly important when working with providers who may have assumptions about pain reporting in people with addiction histories.
This is a question for your specific healthcare team, as the answer depends entirely on your individual circumstances, your addiction history, current recovery status, type of pain, and specific medication. What the research clearly shows is that untreated pain is a significant relapse risk, and that avoiding all pain medication out of fear can be as dangerous as inappropriate opioid use. The goal is adequate pain treatment through the safest available means, determined collaboratively with providers who know your full situation. Non-opioid treatments should generally be explored first; if opioids are genuinely needed, they can be used with appropriate safeguards in coordination with your addiction treatment provider.