Why Is My Brain Foggy with Chronic Pain & What Can I Do about It?

Brain fog is a term used to describe a state of mental confusion or lack of clarity. It can seem as though we have difficulty concentrating, remembering things, making decisions, and have a general feeling of fogginess, or lack of focus. Brain fog can be caused by a variety of factors, including sleep deprivation, poor nutrition, stress, anxiety, depression, and certain medical conditions. It’s not a medical condition itself, but a symptom. If you’re experiencing brain fog and it’s affecting your daily life, it’s important to speak with a medical professional for further evaluation and treatment.

In this article, we explain what chronic pain does to the brain, is brain fog a symptom and how to mentally deal with persistent brain fog.

Let's start with this commonly asked question, is brain fog a symptom of chronic pain? Yes, brain fog is a common symptom of persistent pain problems. More than eight out of every 10 people with widespread pain conditions such as fibromyalgia also report symptoms of brain fog (Heard et al. 2004).

Why is brain fog linked with chronic pain?

It’s thought that chronic pain may lead to brain fog by disrupting sleep, causing stress and anxiety, and altering the levels of certain chemicals in the brain. It’s also simply the case that pain distracts and draws your attention away from other mental processes, making it more challenging to focus on other things.

Here’s a list of some ways in which chronic pain may lead to brain fog:

  1. Sleep disruption: Chronic pain can make it difficult to get a good night's sleep, which can lead to fatigue and brain fog.
  2. Stress and anxiety: Chronic pain can cause stress and anxiety, which can lead to difficulty concentrating and impaired cognitive function.
  3. Chemical changes in the brain: Chronic pain may alter the levels of certain chemicals in the brain, such as endorphins and cortisol, which can affect cognitive function.
  4. Concentration and attention. Pain can completely occupy our thoughts and attention, leaving less brain power for other things. This can contribute to brain fog, with a greater tendency to do things like forget where the car keys are, or to pick up the milk.
  5. Medications: Some medications used to treat chronic pain, such as opioids, can cause cognitive impairment and brain fog as a side effect.
  6. Depressive disorders: Chronic pain is often accompanied by depression, which can cause brain fog and other cognitive impairments.
  7. Diet: Making the effort to prepare healthy meals can be more challenging when you’re in pain and a less than adequate diet can contribute to brain fog since it affects energy supply and hormone levels including insulin.
  8. Inflammation: Some chronic pain conditions are associated with elevated levels of inflammation controlled by the immune system, which is also linked to fatigue and brain fog.

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7 ways to manage brain fog associated with chronic pain

Several of the strategies listed below might help:

  1. Your doctor may be able to adjust your medication or prescribe alternative medications to help reduce brain fog.
  2. If you’re experiencing depression in addition to chronic pain, seeking treatment for your depression is important, and the treatment is likely to help improve your brain fog.
  3. Practice stress management techniques such as those taught in the MoreGoodDays pain management program. Check your suitability.
  4. Ensuring that you get enough sleep can help with brain fog and improve cognitive function. There are many strategies around to promote longer and deeper sleep and your psychologist or health professional is likely to be able to point you in the right direction here. Simple steps for consistently better sleep include early morning sunlight exposure, avoiding screens at night, avoiding late night eating and coffee drinking, and many more.
  5. A healthy diet can provide the nutrients your brain needs to function properly. Try to avoid sweet foods that spike sugar and insulin levels and then cause fatigue.
  6. Exercise is one of the most proven ways to help improve sleep, reduce stress, and improve cognitive function. Exercising early in the morning in sunlight might also help, since movement and natural light signals the brain to wake up.
  7. Inflammation has a direct relationship to pain. Ask your doctor to organise a blood test for inflammatory markers. These tests might include CRP (C-reactive protein) and CGRP (calcitonin gene-related peptide) to rule out large increases in inflammation. Please note though that lower levels of elevated inflammation probably won’t be detected by blood tests. Regardless of test findings, exercise and diet also influence inflammation via the immune system, and managing these factors as a way to manage or combat brain fog and chronic pain can’t be overstated.

It's important to remember that everyone is different, and what works for one person may not work for another. It may be helpful to work through the various strategies with a clinician, and to try a combination of different strategies to find what works best for you.

The effect of chronic pain on the brain & the link to brain fog

The brain adapts to everything we do, whether it is practicing the flute, playing sports or experiencing chronic pain. So, it’s less surprising that chronic pain is associated with changes in brain structure and function. It’s possible that some of these changes not only contribute to the maintenance of pain, but also contribute to brain fog. The levels of some chemicals in the brain, such as endorphins cortisol, appear to be altered in some people with chronic pain. Since these are linked to feeling good and to energy levels, this may also be a contributor to brain fog. The good news is that with better pain management, changes in brain function tend to normalise on their own. So try not to worry too much here, focusing on your general wellbeing is the best approach.

The good news

Brain fog doesn’t have to be another thing on the list of problems to treat. What I mean by this is that pretty much everything that you should do to combat brain fog, is also part of good management for persistent pain: improving sleep, having a nutritional diet, movement, psychological therapies, stress management, etc. Combating brain fog is another good reason for pain sufferers to take active steps and try these strategies.

We all know that getting started can be difficult, because finding motivation when faced with brain fog in addition to pain isn’t easy. Some things are too hard to do alone! Try and get help through a coach, or enroll in a program that will guide you in step by step strategies, and show brain fog the door.