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Most people know that pain is one of the primary symptoms of fibromyalgia, but a phenomenon known as the "fibro fog" that interferes with clear thinking can hit fibromyalgia patients even harder. What can be done to treat it?

What is fibro fog?

The overwhelming majority of fibromyalgia patients experience poor sleep quality and extreme fatigue. This leaves people who are suffering from fibromyalgia feeling run-down and “foggy” — a condition known as fibro fog.

Scientists don’t currently understand what causes fibro fog, but we do have a very clear picture of the symptoms:

  • Not being able to think straight
  • An inability to stay focused
  • Finding it hard to participate in conversations
  • Short term memory loss, signs of which may include losing things, trouble remembering new phone numbers and forgetting that you had planned to meet a friend for lunch

The all-encompassing fatigue fibromyalgia patients go through means that when they wake up, they often feel as if they haven’t slept at all, which is why fibromyalgia is associated with chronic fatigue syndrome. Fatigue is bad enough on its own, but it usually makes pain and other symptoms — including the fibro fog — notably worse. 

The tenderness, fatigue, and pain that are so characteristic of fibromyalgia might sound like the worst part of the disorder, but most fibromyalgia patients actually identify the fog as the symptom that makes their lives hardest. 

Are brain changes linked to fibro fog and fatigue?

You may think more rest would help clear the fog and fatigue, but research shows there might be more to it than simply not being well-rested. Studies indicate that fibromyalgia patients lack oxygen in some areas of their brain, which may be due to alterations and damage in the brain’s blood vessels — this can in turn affect your ability to think clearly. It was also discovered that chronic pain can influence brain function. Tests with Functional MRI scans show that a part of the brain that processes emotion is overactive in chronic pain patients, making neurons “drained”.

What can you do to treat fibro fog and fatigue?


Poor sleep quality is, according to doctors and scientists, tied to fibro fog. Some fibromyalgia drugs have been shown to be beneficial, but increasing the quality and duration of your sleep will really do wonders. To try to achieve better sleep, commit to going to bed and waking up at the same time each day, and keeping your bedroom dark, not too warm, and noise free.


Feeling absolutely terrible doesn’t exactly motivate you to exercise, but you should really consider gentle workout routines like swimming, yoga, or walking, because exercising can offer significant relief from your extreme tiredness. Not exercising, on the other hand, gradually weakens your muscles and leaves you even more exhausted. That doesn’t mean you have to train for a marathon! (Actually, don’t do that unless your doctor says it’s OK.) Making sure you exercise regularly is important, but intense workouts are not right for you.

Working out may also have an unexpected knock-on effect — research has found that a fitter body often leads to a “fitter” brain as well! Working out may not just strengthen your body and lessen your fatigue, it could also take care of some of your fibro fog symptoms. So, how do you get started?

  • Don’t overdo it. It’s best to consult a physical therapist to help you find an exercise program that is just right for you. Following the instructions of someone who understands your condition also helps prevent injuries.
  • Strength training is especially helpful as it builds muscle, which may in turn reduce fatigue and pain. Avoid heavy weights and ask your physical therapist how often and for how long you should train.
  • Yoga is one of the best exercises for people with fibromyalgia, but other disciplines that focus on gentle movements, such as tai chi and qi gong, are also excellent choices!

Train your brain

Combat cognitive difficulties by doing Sudoku, playing solitaire, working on a puzzle, or choosing any other activity that stimulates your brain. Think of your brain as a muscle that can also get stronger with exercise. Engaging in brain training activities may help lift your fibro fog.


People with chronic pain caused by many different conditions often find that they benefit from acupuncture. Although there is no definitive proof that acupuncture reduces fibromyalgia symptoms, you might decide to give this ancient form of alternative medicine a chance.

Take it easy

Prioritize your tasks and leave less important ones for another day if you don’t feel up to doing them. While doing household chores, you can also set a 15 minute timer and then take a five minute break, to make sure you do not overwork yourself and to give yourself a goal to work towards, making it easier to finish. Some people find it useful to keep an activity journal so that they can get a better idea of whether their self-care needs are being met.

Diet and nutritional supplements

Foods that promote healthy brain function include fish, canola, and walnut oil (Omega-3), eggs, and fresh vegetables. Nutritional supplements can also be of great help. Studies show that a vitamin D deficiency makes it more likely that a person will suffer from fibromyalgia, and if you are affected by this, you should take a supplement. Research is also exploring the idea that magnesium supplements can reduce the severity of fibromyalgia symptoms, and that ribose supplements help you think more clearly.

Fibromyalgia medications

Though fibromyalgia does not currently have a cure, medications can go a long way toward managing the condition. Medications approved to treat fibromyalgia and fibro fog include:

  • Pregabalin (Lyrica®),
  • Gabapentin (Neurontin®)
  • Duloxetine (Cymbalta®)
  • Milnacipran (Savella®)

Discuss the pros and cons of trying any of these medications with your doctor, because some of them can induce unpleasant side effects, including in some cases worsening your fibro fog.

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