Say When Symptoms Started and Whether They Keep Coming Back

English time expressions are easy to mix up: "two days ago" uses ago, "for two days" uses for, "since Monday" uses since. This guide makes the symptom timeline clear so you can answer questions like "When did it start?" and "How long has it been going on?" without freezing up.

This article teaches English communication for healthcare situations. It is not medical diagnosis or treatment advice. If you have sudden or worsening symptoms, contact local emergency services or seek medical help right away.

Core Vocabulary

Term	Meaning	Example
onset	The starting moment of a symptom	The onset was very sudden.
sudden	Happening quickly, without warning	It came on suddenly.
gradual	Building up slowly over time	The pain was gradual at first.
since	From a specific point in time until now	I've had it since Monday.
for	Across a length of time	I've had it for two days.
ago	A length of time before now (past tense)	It started three hours ago.
recurring	Happening again and again	It's a recurring pain.
on and off	Coming and going, intermittent	It's been on and off for a week.
first time	The initial occurrence	This is the first time it happened.

Must-Know Phrases

It started [TIME] ago.
I've had it since [TIME / DAY].
I've had it for [DURATION].
It came on suddenly.
It started gradually and got worse.
It's been on and off for [DURATION].
This is the first time this has happened.
It's happened before, about [TIME] ago.
It usually lasts about [DURATION].
It hasn't gone away.
It comes back every [INTERVAL].
I woke up with it this morning.

Since, For, Ago — the Three Words People Mix Up

since + a point in time: since Monday, since 7 a.m., since last week
for + a length of time: for two days, for an hour, for a week
ago + a length of time (with past tense): two days ago, an hour ago, a week ago
Example: The pain started two days ago. = I've had the pain for two days. = I've had the pain since Monday (if today is Wednesday).

Awkward vs Natural Phrasing

Awkward	Natural
I have pain from Monday.	I've had pain since Monday.
It happens before two days.	It started two days ago.
Long time pain, three weeks.	I've had this pain for three weeks.
Sometimes have, sometimes no.	It's on and off. / It comes and goes.
First time never happen.	This is the first time it's happened.

Situational Dialogue

Doctor: When did the symptoms start?

Patient: They started about three days ago, on Tuesday morning.

Doctor: Have you had this before?

Patient: Yes, something similar happened about six months ago, but it went away after a week.

Doctor: Is it constant or does it come and go?

Patient: It comes and goes. It's worse in the morning and better at night.

Replaceable Sentence Templates

I've had [SYMPTOM] for [DURATION].
- I've had a sore throat for four days.
It started [TIME] ago, [SUDDENLY / GRADUALLY].
- It started two hours ago, suddenly.
It [LASTS / COMES BACK] every [INTERVAL].
- It comes back every few weeks.
The last time this happened was [TIME] ago.
- The last time this happened was about a year ago.

Practice

Say this in natural English: a headache that started last night and has not stopped.
Rewrite this so it sounds natural in a clinic: stomach pain for about a week, on and off.
Say this in natural English: it's the first time this has happened.

Reference Answers

I've had a headache since last night.
I've had stomach pain for about a week, on and off.
This is the first time this has happened.

Copyable Pre-Appointment Checklist

Symptom timeline
Started: ___ (date / time)
Onset: sudden / gradual
Duration so far: ___
Constant / on and off: ___
Has happened before: yes / no
If yes, last time: ___ ago
Has it changed since it started: better / worse / same