Fibro Fog and Fatigue

Fibromyalgia goes beyond pain. It can also affect your thinking ability, a symptom called fibro fog, and your energy level, leaving you with extreme fatigue. Even though you feel these symptoms, they aren't visible, and there aren't any tests that can measure them.

You'll need to work closely with your medical team to address your specific challenges with fatigue and fibro fog, because they're a little different for everyone. Do your part by taking steps to conserve energy and overcome concentration and memory issues to power through your day.

They're Real

Severe fatigue -- more than just being tired -- affects up to 4 out of 5 of people with fibromyalgia. It often goes hand-in-hand with sleepless nights. Together, they leave you drained and exhausted.

While scientists are learning more about what's happening in your brain that causes the pain and some other symptoms, what's behind fibro fog remains unclear. That name says it all: a fuzzy-headed feeling that keeps you from thinking clearly. You may get distracted, forget or lose things, and struggle to keep up with conversations.

Over half of people with fibromyalgia say they have these kinds of problems, and many feel the fog impacts their lives more than the pain, tenderness, and fatigue.

Slow but Steady Exercise

Given how you feel, you may want to shy away from exercise. But it's one of the most effective ways to handle fibromyalgia.

When you're too tired to exercise, that lack of activity leads to greater muscle weakness and more fatigue. Over time, regular exercise lessens fatigue. Consistency can have a greater impact than intensity.

It's possible that exercise also creates a positive chain reaction that boosts brain function. Studies show a link between physical ability and thinking ability. People who can do more physically often do better in areas like attention and decision-making.

Start out at an easy pace. Work with a physical therapist to find the right beginner program for you and adapt it as you get stronger. This is especially helpful if you're nervous about exercising.

Strength training helps you regain muscle, and that helps with pain and fatigue for some people. Use resistance bands or a light weight to start.

Very gentle movement therapies like yoga, tai chi, and qi gong all get you moving, but yoga often has best effect on fatigue.

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Scale Back

If you're frustrated by what you can't do, try pacing yourself. Cut back on less important activities to have the energy to enjoy more meaningful ones.

Break down big tasks into manageable bites. As you complete each one, you'll have a sense of accomplishment rather than feel discouraged.

Build in short rest periods between tasks. Keep a journal to find the best activity/rest balance for you.

Get Organized

Use an online calendar or app that lets you color-code activities by importance. Plan work projects and home responsibilities at least a week in advance.

Then take a big-picture look. Are there too many high-priority items and not enough down time? Make adjustments, even if it means sometimes saying "no."

Make Your Day More Fibro-Friendly

Take a fibromyalgia education program to learn healthy behaviors and how to tweak everyday activities for less stress.

If you work outside the home, talk to your employer about things that might help you do your job:

  • Take breaks more often
  • Change your work schedule
  • Switch to a different position that better matches your abilities

A psychologist or neurologist may be able to suggest more adaptations, or use biofeedback or cognitive behavior therapy to boost your focus. An occupational therapist can show you how to make physical changes, from a better workstation to stretches you can do at your desk.

Better Sleep

There's a strong connection between sleep quality and your level of fatigue. While some fibromyalgia medications may help, they may not be enough. In addition to regular exercise and pacing yourself, practice good sleep habits. These include a regular bedtime and wake-up time and a dark, cool, quiet room

Some people with fibromyalgia have a second condition that causes fatigue, like an inflammatory disease, anemia, or low thyroid. Get tested and, if needed, treated.

Help Others See What You Feel

Because fibro fog and fatigue aren't obvious, it can be hard for friends and loved ones to understand what you're dealing with.

Let the people in your life know that you have a disease that affects your muscles and causes pain, fatigue, and thinking problems. It might help to say researchers are pretty sure that certain areas of the brain don't process nerve signals correctly, leading to a wide range of symptoms.

When you ask for help -- and it's OK to do that -- be specific about what you need.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on August 23, 2017

Sources

SOURCES:

Pain Practice: "Energy Expenditure during Functional Daily Life Performances in Patients with Fibromyalgia."

Current Pain and Headache Reports: "Cognitive Impairment in Fibromyalgia."

PLoS ONE: "Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome -- Prospective Clinical Trial."

Arthritis Foundation: "Fibro Fog," "Explaining Fibromyalgia to Other People."

NeuroImage: Clinical: "Characterizing 'fibrofog': Subjective appraisal, objective performance, and task-related brain activity during a working memory task."

Rheumatology International: "Fibrofog and fibromyalgia: a narrative review and implications for clinical practice."

Pain Management: "How to manage fatigue in fibromyalgia: nonpharmacological options."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Questions and Answers about Fibromyalgia."

Clinical Rheumatology: "Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: state of the art and implications for clinical practice."

National Fibromyalgia Association: "Treatment."

WomensHealth.gov: "Fibromyalgia."

UpToDate: "Treatment of fibromyalgia in adults not responsive to initial therapies."

Mayo Clinic: "Fibromyalgia: Treatment."

American Family Physician: "Common Questions About the Diagnosis and Management of Fibromyalgia."

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