Cognitive Abnormalities And Fibro Fog

Along with all the physical symptoms of fibromyalgia, there are also cognitive issues that can develop. Unfortunately for many people diagnosed with fibromyalgia, especially those that are older, the cognitive changes that develop because of fibromyalgia may be chalked up to old age. Many people that have the cognitive changes common to fibromyalgia will find that they are forgetful, have trouble concentrating, have increased difficulty in memorizing or learning or even in recalling a specific memory. Some people even develop difficulty in recalling words, even common words, which greatly impacts socialization, comfort in speaking with others and overall self-esteem.

The cognitive abnormalities seen with fibromyalgia are collectively known as fibro fog, which is also sometimes written as fibrofog. Regardless of how you spell this symptom, it is definitely a problem and can be one of the most emotionally devastating and stressful symptoms of fibromyalgia. To further complicate the problem fibro fog tends to occur in episodes that last from a day or two to weeks or even months. Keeping a journal of when fibro fog occurs can be helpful in tracking and reporting.

Symptoms of Fibro Fog

As the name implies, fibro fog is haziness or fogginess in various aspects of the thinking processes. Like fog it comes and goes and is often worse when pain symptoms are not effectively managed. Fibro fog may make it almost impossible to remember specific things or even very general routines. Many people with fibro fog become very easily confused when presented with information, and they may have difficulty in understanding the spoken or written word.

Others may have problems with writing or math and may seem to have no recollection of specific numbers. This can include PIN numbers for debit or bank cards, addresses, phone numbers or even something as commonly used as a Social Security Number. Short term memory loss is also very common making it easy to remember things from your past but not easy to remember what you had for breakfast or if you took your meds.

It is absolutely important to realize that fibro fog is not the same as dementia or Alzheimer’s, and it is not a degeneration of the cognitive functioning that is permanent. While there is no cure for fibromyalgia and fibro fog, there are some medical or alternative treatment options that can help to control the severity of the fibro fog symptoms. In addition there are simple techniques and daily strategies that can help you to remember, plan and stay organized, even if you are having a difficult day or week with cognitive functioning.

In studies, individuals with fibromyalgia and fibro fog tend to rate themselves lower on scales testing cognitive abilities. However, the greater the physical symptoms, including sleep loss and pain, the higher the levels of cognitive loss reported. This tends to show that there are multiple variables that impact fibro fog and cognitive ability, but that pain and emotional state may play very instrumental roles.1

What Causes The Condition?

Just how cognition, memory and brain functioning is affected in some people with fibromyalgia, but not in all, is still not understood. It is definitely not a problem with the individual’s mental capacity, but more likely a connection between the hypersensitivity to pain, sleep disruptions and concurrent mental health conditions such as depression or anxiety that create the problem. Research into the role of interrupted REM sleep, the deep restful sleep, has shown that memory recall is altered with REM sleep loss. 2

Another theory that has been tested includes the change in the brain in individuals that have a diagnosis of fibromyalgia. New types of technology can track changes in the brain at a much more detailed level than MRIs or other types of standard technology typically used. Research in the neuroscience field has demonstrated that there are changes in many different features of the entire central nervous system. These include chemistry changes, anatomical changes, as well as actual changes in brain and central nervous system physiology. 3

The specific anatomical and physiological changes have actually been measured against health and age matched controls. People with fibromyalgia, in a study of 20 patients compared to 22 non-fibromyalgia healthy individuals, found that the grey matter in different parts of the brain was different. This included changes in the right temporal gyrus, left posterior thalamus, left orbitofrontal cortex, left cerebellum and other parts of the somatosensory system in the brain and central nervous system. 4

What researchers are not clear about is if the changes occurred prior to the symptoms of fibromyalgia, or if the constant chronic pain and changes to the HPA axis and responses of the central nervous system from the pain resulted in the grey matter change. More research into the chemical and structural changes in the brain during the early stages of fibromyalgia would be beneficial; however, the condition is often not diagnosed for years, limiting early research options.

Dealing With Fibro Fog

There are medications, especially antidepressants, and specific treatments to limit the severity and duration of periods of intensive pain. Since fibro fog flare ups and pain flare ups tend to go hand in hand this may be a very effective management option.

Other simple techniques to help when you have memory problems include keep to a schedule or routine with as few variations as possible. Putting medications in a daily pill container and having a friend or family member call at a set time to check that you have taken your meds can be very helpful. Be sure to talk to friends and family and ask for help with remembering important events and activities.

It is also important to have the conversation to ensure that people understand if you forget a birthday or don’t show up for a get together. The more help and support you can get, both in your routine and daily living as well as with meds to help with pain management, sleep and mood stabilization, the more effectively your fibro fog can be managed.


1 Williams, D. A., Clauw, D. J., & Glass, J. M. (2011). Perceived Cognitive Dysfunction in Fibromyalgia Syndrome. Journal of Musculoskeletal Pain , 66-75.

2 Fischer, S., Diekelmann, S., & Born, J. (2011). Sleep’s role in the processing of unwanted memories. Journal of Sleep Research , 267-274.

3 Schweinhardt, P., Sauro, K. M., & Bushnell, M. C. (2008). Fibromyalgia: A Disorder of the Brain? The Neurosceintist , 415-421.

4 Schmidt-Wilcke, T., Leurding, R., & Weigand, T. (2007). Striatal grey matter increase in patients suffering from fibromyalgia – A voxel-based morphometry study. Pain , S109-S116.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015