Preparing for Surgery With Chronic Pain: A Pre-Op Pain and Medication Log

Updated 3 October 2026

Surgery adds new pain to pain you already have, and the team planning your care needs to know the difference. The weeks before the operation are the time to write down your usual range, your bad days, and everything you take.

This guide covers why chronic pain changes surgical preparation, how to build a baseline, how to list medicines and supplements, what else the anesthesia team asks about, how to track mood and worry, what to bring to the pre-op visit, and how to plan the first days at home. Your surgical and anesthesia teams' instructions come first.

Why chronic pain changes how you prepare for surgery

Chronic pain does not pause for an operation. An umbrella review of 36 reviews defines chronic postsurgical pain as pain, mostly at the surgical site, that lasts longer than 3 months after a procedure, and reports that depending on the surgery it can affect between 10 and 80% of people having major operations (Sydora et al., 2024). The same review found a consistently high level of evidence for preoperative pain, depression, anxiety, and pain catastrophizing as risk factors, and notes that many risk factors can be changed.

That is a reason to prepare, not to worry. In seven principles agreed by the American Society of Anesthesiologists and 14 other specialty organizations, clinicians are told that when a preoperative evaluation identifies chronic pain, they should coordinate with the patient's care team, including consultation with a pain medicine specialist (American Society of Anesthesiologists). Your log gives that team the facts.

From Chronic Pain Journey (by Health Journey Labs), we recommend keeping the pre-op log to two parts: a daily pain and function record, and a medicine and supplement list that stays up to date. Start as soon as a date is set, since a few weeks of entries show your usual range.

In Chronic Pain Journey, Learn offers short topics and prompts on pacing, sleep, flares, visit prep, and fog, tied to your own logged weeks. They help you turn a surgery date into a short list of things to track. Read with your entries, the topics show a pattern worth acting on: which area, such as sleep or pacing, deserves a closer look before the operation.

How to build a pain baseline in the weeks before the operation

Pre-op baseline checklist, by Chronic Pain Journey

After surgery, everyone asks how your pain is. Without a baseline, your answer has nothing to compare with: is a 6 out of 10 a bad day or your normal? A baseline taken before the operation lets your team separate pain from the procedure from the pain you already live with.

For two to four weeks, record the same few items each day:

• ☐ the worst and usual pain intensity
• ☐ the pain location
• ☐ the activities it stops
• ☐ the hours of sleep
• ☐ a short line on the day

Add the sites that matter for the surgery, such as the area being operated on and any pain elsewhere. Note activity and pacing as well, including the tasks you hand to someone else.

Include your own words for the pain: burning, aching, stabbing, or electric. Those descriptions help the pain or anesthesia team plan, and they make later changes easier to describe.

Each day, the Daily check-in of Chronic Pain Journey asks about pain level, fog, pacing or activity, and how the day went, together with sleep, nutrition, exercise, and medicines. Each day uses the same questions, so the baseline builds without extra effort. Over several weeks the history shows your normal range, a pattern that gives post-op numbers something to be compared with.

How to log flares and bad-pain days so the team knows your range

Flare day checklist, by Chronic Pain Journey

Most people with chronic pain have a usual hard week and then days that are clearly worse. Surgical teams plan pain control around what they expect, so tell them what the worst of your range looks like and how often you reach it. Without it, a post-op pain level may be judged against a quiet day.

On a flare or bad-pain day, write:

• ☐ the date
• ☐ the onset
• ☐ a 0 to 10 intensity
• ☐ the activity at the time
• ☐ the things you tried
• ☐ the duration

Record sleep, stress, and any change in routine just before it. A few of these entries show triggers, and they show how quickly you usually recover, which helps your team judge whether post-op pain is following your usual path.

Also note whether pain has shifted in character or location in recent weeks, since a change can be a reason to call your clinician before surgery. For help getting through a hard day with your notes intact, see getting through a chronic pain flare day without losing notes.

The Flare Tracker in Chronic Pain Journey marks a day that stands far above your usual rough week, holding its onset, intensity, and a short note. One tap does it, even on a high-pain day. Across weeks, the flags show whether a spike stood alone or came back in a pattern, which tells the team how high your range goes.

How to record every medicine, supplement, and as-needed dose for the anesthesia team

Checklist of medicines on hand, by Chronic Pain Journey

The American Society of Anesthesiologists asks patients to tell their physician anesthesiologist about anything they take for their health. It notes that many medications can affect anesthesia or pain management, that some, such as blood pressure medications, should be continued even during surgery while others may need to be paused for a day or longer, and that certain supplements can interact with anesthesia. It suggests bringing supplements to the presurgical appointment or photographing the ingredient list (ASA). The team decides what to continue or pause.

For people on long-term opioid therapy, the 2022 principles tell clinicians to coordinate with the prescribing clinician and continue the baseline dose in the perioperative period, with supplemental pain relief as needed (American Society of Anesthesiologists).

MedlinePlus advises bringing a list of medicines to every provider visit, including those bought without a prescription and those not taken every day, with the dose and how often you take each, and asking your surgeon which medicines to still take on the day of surgery (MedlinePlus). List every item:

• ☐ prescription medicines
• ☐ over-the-counter pain relievers
• ☐ supplements
• ☐ cannabis products
• ☐ creams or patches

For each, write the name, the form, how you take it as directed, how often you actually use as-needed doses, and the reason. Never stop or change anything on your own before surgery. See also tracking chronic pain medicines alongside pain and fog weeks.

My Meds in Chronic Pain Journey keeps each medicine's name, timing, and dose, plus any as-needed doses you take, and shows them with pain, sleep, fog, and the rest of the tracked history. Open it at the pre-op visit and the list is already there. Over time, you can see whether pain scores moved when a medicine changed, a pattern your team can use (Chronic Pain Journey checklist).

What else the anesthesia team asks about: sleep, snoring, alcohol, and other conditions

List of sleep factors, by Chronic Pain Journey

The ASA's list of things to tell a physician anesthesiologist includes smoking, marijuana, alcohol, snoring that may signal sleep apnea, a past reaction to anesthesia, and chronic health problems such as diabetes, heart disease, liver or kidney disease, asthma, high blood pressure, and seizures. It says the physician anesthesiologist is not there to judge but to provide the safest, most effective anesthesia and pain relief (ASA).

• Fold these into your daily log in a few lines: the nights you snore or wake gasping, how much alcohol you have, whether you use tobacco or cannabis, and other conditions you manage.
• Past reactions to anesthesia belong on a separate line, with the date and the procedure.
• Chronic pain and poor sleep often feed each other, so sleep hours and wake-ups are worth recording.
• Bring up concerns too.
• If you worry about taking opioids, the ASA says the physician anesthesiologist can discuss alternatives.
• Write your worries down in the log so you do not forget them in the room.

The Food Tracker in Chronic Pain Journey takes meal or drink lines, including caffeine and alcohol, and puts them beside louder pain, energy, and sleep. A few weeks of entries show your honest pattern, ready to share. Nothing in the pre-op conversation then depends on memory alone; the habit of logging does the remembering.

How to track mood, worry, and pain beliefs before surgery

Things that helped list, by Chronic Pain Journey

The umbrella review found a consistently high level of evidence that preoperative depression, anxiety, and pain catastrophizing are linked with chronic postsurgical pain, and its plain-language summary says that psychological risk factors consistently showed a strong impact (Sydora et al., 2024). The authors point out that many risk factors can be changed. That is useful news: worry before surgery is common, and support is available.

Rate your mood and your worry about surgery once a day from 0 to 10, with one line on what drove them. Note thoughts that spiral, such as "this pain will never end", and how often they show up. Record which things helped, such as:

• a call with a friend
• a walk
• a breathing exercise
• a conversation with the team

Tell your clinician if low mood or anxiety lasts for several days or interferes with sleep, eating, or daily tasks, since support before surgery is something teams can arrange. If you start thinking about harming yourself, call your local emergency number immediately, and ask a crisis line for support too.

My Assessments in Chronic Pain Journey holds structured check-ins that go deeper than the daily scores, along with onboarding questions about life and social context. The Daily Journal adds typed or voice notes on visit debriefs, partner talks, and leftover guilt. Reading both shows a pattern: whether low days follow poor sleep, flare weeks, or news from the clinic.

Bringing your chronic pain history to the pre-op consultation

Pre-op summary checklist, by Chronic Pain Journey

The 2022 principles also say that, for patients at significant risk of opioid-related adverse events or severe uncontrolled perioperative pain, clinicians should consult a pain specialist or anesthesiologist before the operation (American Society of Anesthesiologists). If your chronic pain is complex, ask your surgeon whether that consultation can be arranged, and whether it can happen by telehealth when an in-person visit is hard to get.

Bring a one-page summary with:

• ☐ your baseline pain range
• ☐ your bad-day frequency
• ☐ the full medicine and supplement list
• ☐ sleep and snoring notes
• ☐ mood notes
• ☐ past reactions

Bring three or four questions. Which of my medicines continue before and after surgery? Who manages my long-term pain treatment while I recover? What is the plan for pain relief in hospital and at home, and who do I call if it fails? Write the answers in the visit notes. For a short-visit checklist, see preparing a short visit with your pain notes.

Before the pre-op visit, Chronic Pain Journey can compile your entries into a one-page Doctor Report with dates, pain and flares, sleep, fog, meds, and how you functioned. My Care Team is where clinician names and brief visit notes live: questions to ask, jotting during the appointment, and review afterward. After the visit, the notes show which pattern of questions got answers and which are still open.

How to plan the first days at home and which signs need urgent help

Planning the first days at home with chronic pain

The 2022 principles say patients prescribed opioids at discharge, and their caregivers, should be told about the risks, signs, and management of opioid-induced respiratory depression, that medicines with sedative effects and alcohol must be avoided while taking opioids, and when to call for emergency assistance (American Society of Anesthesiologists). Ask for that information before you go home, and make sure the person staying with you hears it too.

Write down a home plan before the operation: who stays with you, who handles the school run or meals, and what your pain-medicine instructions are as the team gave them. Keep the log simple after surgery: pain by site, function, sleep, medicines taken as directed, and the wound. Compare each day with your baseline.

Call your local emergency number for trouble breathing, chest pain, fainting, or someone who is hard to wake or breathing very slowly. Contact your surgical team the same day for fever, spreading redness or drainage at the wound, a swollen painful calf, or pain that suddenly changes. Keep the team's own list within reach.

In Chronic Pain Journey, Weekly Goals let you set one small aim, such as one short walk or one planned rest block, and record whether it held. AI companions like Clara already see your logged history, so they can help with a calm script for the person helping at home, a soft line for work, or a steady voice after a high-pain day. Together they build a recovery habit that you can adjust as the weeks go on.

How Chronic Pain Journey can help

Paper works for a short pre-op log. The harder part comes when entries pile up: pain range against sleep, medicine changes against flare days, and the baseline against what you feel after the operation. You can compare tracker options in Best Chronic Pain Apps 2026: Trackers Compared.

Chronic Pain Journey is a personal chronic pain tracker from Health Journey Labs on the App Store and Google Play. It gives you one place for daily pain and function ratings, flagged bad days, a current medicine list, and test dates in the weeks before surgery. Weeks of dated entries give your surgical and anesthesia teams a clear baseline, which makes it easier to tell new pain from the pain you already carry. Below is what you can use and how each part helps.

• Daily check-in — A single guided pass each day over symptoms, mood, food, sleep, exercise, medicines, and outside factors, with fields for how strong the pain is, fog, pacing or activity, and how the day went.
• Flare Tracker — A mark for a day that stands far above your usual rough week, with the onset, the intensity, and a brief note.
• Daily Journal — Typed or spoken notes on what you canceled, talks with a partner, visit debriefs, lingering guilt, or a meeting that slipped away, which give your scores their backstory.
• Weekly Goals — A single modest target for the week and a record of whether it held, set against the actual check-ins.
• My Meds — The name, timing, and dose of each medicine, plus as-needed use that actually happens, viewed with pain, sleep, and fog.
• AI companions — Clara for general conversation plus specialist companions for knowledge, fitness, nutrition, and relationships; each can see your logged history, so they can help word a question for a visit, write a calm script for a partner, draft a soft line for work, or offer a steady voice after a high-pain day.
• Doctor Report — A one-page export of your logged history showing dates, pain, flares, rest, fog, medicines, and daily function.
• My Labs — When imaging, blood work, and other tests were done, read beside function and pain.
• Learn — Brief topics and prompts on pacing, sleep, flares, visit prep, and fog, connected to the weeks you have logged.
• My Assessments — Structured check-ins that go further than the daily scores, plus onboarding questions about your life and social setting.
• My Care Team — Clinician names and short visit notes for planning what to ask and bring, writing during the appointment, and reviewing it afterward.
• Food Tracker — Meal and drink lines, viewed with louder pain, energy, and sleep.
• Weight Tracker — Scale or body notes, viewed with energy, sleep, and pain weeks.
• Period Tracker — The dates a period starts and stops, plus flow and whether it was heavy or light, set against pain, energy, and everything else you log.

Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.

Sources

• Sydora BC, et al. Identification of Presurgical Risk Factors for the Development of Chronic Postsurgical Pain in Adults: A Comprehensive Umbrella Review. J Pain Res. 2024
• American Society of Anesthesiologists — 15 Medical Societies Develop Best Practices to Manage Acute Pain in Complex Surgical Patients (2022)
• MedlinePlus — Getting yourself healthy before surgery
• American Society of Anesthesiologists — Eight Things to Tell Your Physician Anesthesiologist Before Surgery (2019)

FAQ

The answers below draw on the sources cited in this guide, and the app they mention is Chronic Pain Journey (by Health Journey Labs).