I've never had luck with getting ANY doctor to give more than a cursory glance to my pain journal.

I recommend having a spouse or good friend be there to be your advocate. I usually don't have issues with not speaking up when I think the occassion warrents it, but for some reason, I have with doctors when discussing my pain issues. That could be in part that I've been told so many times, "It's all in your head" or "I hope that you aren't going to ask for narcotics" or "You just need to work harder in PT." I have no problem advocating for my mom with her many pain and health issues, but I now panic with those docs who have been less than supportive of helping me maximize my comfort and functionality. If you have someone that can go with you to advocate for you getting better control over your symptoms and your life, that might help.

Having a list of points that you want to bring up can also help. If you start by saying, "I want to make sure we cover my issues with x,y,and z, so I have a plan going forward"....at least you will be sure all your points were at least mentioned instead of spending a lot of time on one small part of the problem