The Physicality Of Fibrofog, The Brain, And Pain

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Those of us with fibromyalgia know fibrofog and so do researchers. Some suggest the array of cognitive difficulties could be directly related to our brain just like our pain.

cognitive – relating to, being, or involving conscious intellectual activity
(such as thinking, reasoning, or remembering (Merriam-Webster)

More than forgetfulness

Fibrofog affects our memory, concentration, attention, and the way we organize and process information. It is with us every day, all day. Unlike normal forgetfulness, it interferes with the way we relate to others and our ability to categorize and access certain information. The following will show that fibrofog is far more than the effects of normal aging.

Memory measures

Two things help us understand how our brain is affected:  1) objective tests and 2) our symptoms.

Research using objective tests suggests cognitive mechanisms most affected in fibromyalgia are working memory, episodic memory, and semantic memory.

  • Working memory – short-term storage of data required for complex tasks such as learning, processing facts, reasoning, and decision-making. We use our working memory when we calculate a tip.
  • Episodic memory – memory associated with “episodes,” the what, where, and when of our past, for instance, recalling where we lived as a child.
  • Semantic memory – a cumulative cognitive process that allows us to recall general facts, such as knowing a doctor is a healthcare provider.

Symptoms include things like:

  • difficulty finding commonly used words
  • dyslexia (transposition of letters or numbers)
  • impaired concentration
  • impaired verbal skills
  • inability to recall names of people we know
  • forgetting plans
  • misplacing objects
  • inability to follow simple instructions
  • short-term memory loss
  • inability to retain new information
  • difficulty navigating to a familiar destination
  • inability to complete complex tasks

Researchers Ambrose, et al., suggest problems with processing and attention are not only related to depression and/or poor sleep, they can also be attributed to pain intensity. This makes sense because in 2017, researchers found a brain signature in FM that shows abnormal physiology regarding the way our brain responds to pain.

Contributors to Fibrofog

Why certain cognitive factors are present in fibromyalgia is unclear. But, we do know fibrofog may be aggravated by:

  • hypothyroidism
  • ME/CFS
  • chronic pain from a second source
  • metabolic disorders
  • hormonal fluctuations
  • sleep disturbance and non-restorative sleep
  • anxiety, stress, or depression
  • mental or physical fatigue
  • diet high in carbohydrates
  • nutritional deficiency or bowel malabsorption
  • toxicity, such as mold or metal
  • medication side effects
  • other medical condition affecting the brain or blood flow

​​Nearly two decades ago, I underwent a two-day neuropsychological exam, which showed gross deficits in my short-term memory. Though it was validating, I didn’t need a test to tell me my brain was not functioning the way it should. For instance, I cannot remember a keyword long enough to add it to a draft.

The deficits I experience make writing more difficult, but thanks to technology, my love of a challenge, and the power of “I can,” I have found a way to make it work. And, I have learned—if someone says I forgot something, I probably did!

In conclusion

Objective tests are helpful, but they don’t specifically measure fibrofog. That’s why assessment should also focus on our reported symptoms. Our friends, family, and sometimes even our healthcare providers don’t realize the differences. But there is scientific evidence that verifies what we experience is more than forgetfulness. We know this, so we shouldn’t take what others say personally. We can’t change it, so we should work on accepting it. When we accept it, we can boldly share the research and our symptoms with those who need to know that fibromyalgia is more than pain.

“The advantage of a bad memory is that one enjoys several times
the same good things for the first time.”

~ Friedrich Nietzsche ~


Celeste Cooper, RN, is a frequent contributor to ProHealth.  She is an advocate, writer and published author, and a person living with chronic pain. Celeste is lead author of Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain and Broken Body, Wounded Spirit, and Balancing the See Saw of Chronic Pain (a four book series). She spends her time enjoying her family and the rewards she receives from interacting with nature through her writing and photography. You can learn more about Celeste’s writing, advocacy work, helpful tips, and social network connections at CelesteCooper.com.

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