Pros and Cons of Keeping an MS Symptom Diary

Keeping a symptom diary can be a powerful tool for people living with multiple sclerosis (MS). Whether you’re newly diagnosed or have been managing MS for years, tracking symptoms over time can help you and your healthcare team recognize patterns, identify triggers, and make more informed decisions about your treatment plan.

A symptom diary can take many forms — a notebook, a calendar, or a mobile app — and there’s no single best method, says Diana Vargas, MD, assistant professor of neurology and neuroimmunology at Emory University in Atlanta.

“The best method is the one that works for you and fits easily into your daily routine. Consistency matters more than format,” says Dr. Vargas.

Are you wondering if being more intentional with symptom tracking could make your healthcare appointments more productive and help you better manage your MS? Keep reading to understand the benefits and potential drawbacks of keeping an MS symptom diary.

An MS symptom diary is exactly what it sounds like. As mentioned above, the diary can be electronic or old-school, but ideally the entries should include the date, time, and symptoms you experienced, as well as the environment you were in or activity you were doing when they occurred.

Keeping track of your symptoms is an effective and inexpensive (often free) tool that has a lot of benefits, says Vargas. The pros of keeping a symptom diary include the following:

1. It Can Help Identify the Start of Relapses

MS symptoms can change from day to day, and sometimes it’s hard to tell whether you’re experiencing a temporary flare-up or something more significant. A diary can make those distinctions clearer.

“A diary of your symptoms helps your neurologist determine if changes suggest a relapse, progression, or a side effect of a medication,” Vargas says. By noting when a new symptom begins or when existing symptoms worsen, you and your neurologist can identify potential relapses sooner.

2. It Helps Differentiate Between Relapses and Pseudoexacerbations

Not every symptom flare is a relapse, which by definition means there’s new inflammation in the central nervous system. Sometimes heat, stress, or an infection can temporarily worsen symptoms, but without new inflammation in the central nervous system. These are known as pseudoexacerbations.

3. It Can Reveal Triggers

Recording your symptoms and daily circumstances can reveal what’s triggering your symptoms or relapses.

As you document these things, you may start to notice connections — for example, elevated temperatures leading to blurred vision, or increased stress leading to worsening fatigue, says Vargas.

“Recognizing patterns is essential in symptom management, as it empowers you to make lifestyle adjustments and thus avoid overmedicating for symptoms that can easily be avoided,” she says.

“Over time, you’ll better understand what’s normal for you and what feels new or concerning,” says Vargas. “That helps us act earlier if needed.”

4. It Tracks the Effectiveness of Treatments

A diary can provide valuable information about the effectiveness of treatments.

“Noting symptom changes after a new medication, physical therapy routine, or any other recommended intervention will help us identify what may be a side effect, assess what’s working and we should continue, and what is not and we should stop,” says Vargas.

5. It Can Help Identify Health Problems Not Caused by MS

Not every symptom is necessarily tied to MS. Tracking can reveal when an issue may be unrelated — for example, a new kind of pain, like headaches or joint pain.

Having a record of your experiences gives healthcare providers context and can prompt them to look for other causes.

6. It Improves Communication With Your Doctor

Recalling symptom details at appointments can be difficult, especially if you’re feeling stressed or rushed. A diary provides concrete examples to discuss, such as how long fatigue lasted or how often balance issues occurred.

“It facilitates better communication and makes the visit more efficient,” says Vargas.

Reviewing your diary right before your appointment is also a good idea, she adds.

As with any tool, there are some potential downsides to keeping a log of your symptoms.

1. It Can Feel Like One More Thing to Do

“Fatigue, more so at the end of the day, may make it so you don’t feel like you have the energy to do anything extra. Inconsistent tracking may also make you feel discouraged, even though occasional gaps are completely normal,” says Vargas.

2. It Can Increase Anxiety or Stress

Constantly monitoring symptoms can heighten anxiety or make you more aware of discomfort.

“Living with MS is already overwhelming, and if you’re forced to constantly think about your symptoms, you may end up increasing your stress and anxiety levels and make yourself feel worse,” Vargas says.

3. It Can Reinforce a Sense of Illness

For some, diary keeping can make them feel defined by MS.

“It can keep you focused on the negative and reinforce a perception of yourself as someone who is sick,” Vargas notes.

If tracking starts to feel like a burden or makes you more worried, choosing a simplified method like a calendar or an app may be better than a diary, she says.

4. You Might Feel Guilty or Self-Critical

Tracking can spotlight days when symptoms flare despite your best efforts, or when you forget to log entries.

“It may lead to frustration if you are trying to remember symptoms while already having problems with memory,” says Vargas.

Overall, most experts agree that keeping an MS symptom diary can help you and your healthcare team improve how you manage your condition.

Vargas recommends the following tips, which can help you take advantage of the benefits and minimize any downside:

Keep it simple. The most important tip is to keep it simple. Use scales, like 0 to 10 for pain or fatigue, and short keywords for symptoms, so logging them only takes a couple of minutes.

Focus on changes. You do not need to record every day if nothing happened. Instead, focus on new symptoms or significant changes.

Include context. When symptoms occur, note what was happening in your daily life at the time, such as your sleep quality, stress levels, weather, infections, menstrual cycle (if applicable), exercise, or missed medication doses.

Track mood and cognition. Mood changes, brain fog, and fatigue can often be overlooked or dismissed as not related to MS. But depression and other mood disorders, as well as problems with thinking and memory, can be MS symptoms and should be discussed with your neurologist, as help may be available.

Review your symptom diary before doctor appointments. Be sure to read over your diary or app inputs the night before or morning of your doctor appointment. If you have identified new triggers or noticed patterns in your symptoms, tell your doctor. It may help your doctor be more efficient at determining what’s going on and make the visit more productive.

Know when to stop or pause. If your symptoms are stable, or tracking them becomes stressful or just isn’t for you, it’s okay to take a break or stop. Keeping a symptom diary is supposed to help with managing MS, not be an additional stressor in your life.

Choose a format you’ll actually use. Paper and pen can be ideal if you like to jot down quick notes or sketch sensations. A calendar (paper or digital) is great for tracking symptom frequency and patterns — and it may give insight into what else was happening in your life at the time.

Smartphone apps are very popular and especially helpful because many are designed for managing MS specifically (or chronic illnesses generally). They often include symptom scales, reminders, lists of possible triggers, and even reports you can share with your neurologist.

The My MS Manager app, supported by the Multiple Sclerosis Association of America, offers that kind of functionality.

• Keeping an MS symptom diary can help you spot relapses early, identify triggers, and communicate more effectively with your care team.
• Choose a method that feels natural, whether a notebook, calendar, or app.
• Tracking can sometimes increase stress or make you overly focused on your condition, so adapt the method and frequency of your tracking as necessary to support your emotional well-being.
• A symptom diary is a tool, not an obligation. Use it to understand your MS more clearly and collaborate better with your healthcare team.