Many people with inflammatory arthritis struggle with more than just joint pain, stiffness, and fatigue. One “invisible” symptom that’s increasingly recognised is brain fog: that sense of mental fuzziness, difficulty concentrating or remembering, and slowed thinking. This article explores what we know (and don’t yet know) about brain fog in arthritis, what might cause it, and what you can do to manage it.
What is “brain fog”?
“Brain fog” is not a medical diagnosis, but a colloquial way to describe a cluster of cognitive symptoms, such as:
-
Difficulty concentrating or staying focused
-
Memory lapses or trouble recalling information
-
Slower thinking or mental processing
-
Trouble multitasking or “keeping track” of ideas
These symptoms may come and go and vary in severity. In people living with inflammatory arthritis, brain fog is often part of a broader pattern of cognitive impairment (difficulties in thinking, processing, or memory ) that may be under-recognised in clinical care.
What brain fog might “look like” in daily life
Here are some examples that patients frequently report:
-
Reading a paragraph several times but not remembering it
-
Struggling to find words in conversation
-
Losing track mid-sentence or forgetting what you meant to say
-
Mistakes at work, or more time needed to complete mental tasks
-
Forgetting appointments, misplacing items
-
Feeling “slow,” “fuzzy,” or mentally tired, even when physically rested
Because brain fog is less visible than joint swelling or pain, patients often feel invalidated; “everyone forgets things now and then”, and may hesitate to talk about it, even though it can significantly affect quality of life.
What you can do: strategies to manage or reduce brain fog
While research is ongoing, several practical strategies (supported by clinical experience and related studies) may help reduce the burden of brain fog. These are not one-size-fits-all, and should be discussed with your rheumatology or medical team, especially if you are considering any changes to medications or supplements.
-
Aim for optimal disease control
-
Keeping inflammatory activity low is likely one of the strongest ways to reduce cognitive burden.
-
Speak with your rheumatology team if you feel that your treatment is not sufficiently controlling inflammation, sometimes adjustments or switching therapy can help.
-
-
Prioritise sleep hygiene
-
Create consistent sleep and wake times
-
Make your bedroom dark, quiet, and cool
-
Limit screens before bed
-
Address sleep disorders (e.g. sleep apnoea, restless legs) with your GP
-
-
Manage pain and fatigue proactively
-
Use pacing strategies: break tasks into shorter episodes with breaks in between
-
Use assistive devices when needed (e.g. reminders, voice commands, note-taking apps)
-
Do gentle, regular movement or stretching (as tolerated) to reduce stiffness and boost circulation
-
-
Train your brain
-
Engage in mentally stimulating activities: puzzles, crosswords, reading, memory games
-
Use “external memory aids”: lists, reminders, calendar apps, voice notes
-
Give yourself extra time and reduce multitasking
-
-
Lifestyle supports
-
Physical activity: even light exercise has been associated with better cognitive health
-
Diet: consider foods with anti-inflammatory benefits (e.g. fish, vegetables, nuts), though evidence in arthritis specific brain fog is less clear
-
Stay socially connected: conversation, socialising, and shared activities help keep your brain engaged
-
Stress reduction: mindfulness, breathing techniques, guided relaxation, therapy as needed
-
-
Address mood and mental health
-
If you have symptoms of depression or anxiety, seek help (counselling, cognitive behavioural therapy, medication as appropriate)
-
Mood symptoms, when treated, can reduce cognitive interference
-
-
Medication review
-
Periodically review your medications with your clinician to assess side effects, interactions or cumulative burden
-
Avoid starting “brain fog cures” (such as unverified supplements) without medical advice
-
-
Regular monitoring and communication
-
Keep a journal or app to note when brain fog is worse (e.g. during flares, poor sleep, certain times of day)
-
Share these observations with your doctors, patterns may emerge that can help tailor your treatment
-
Ask whether cognitive screening (e.g. simple memory tests) could become part of your routine care
-
When to raise concerns with your care team
If brain fog becomes:
-
Progressive or worsening
-
Interfering significantly with daily life, work, or self-care
-
Accompanied by neurological symptoms (e.g. sudden confusion, weakness, balance problems)
…then it’s especially important to discuss with your GP or rheumatologist, as other treatable causes should be ruled out (such as thyroid disease, vitamin deficiencies, medication side effects, or neurological conditions).
–
Summary
Brain fog is a real and often distressing symptom for many people with inflammatory arthritis. While the science is still evolving, the evidence suggests that systemic inflammation, pain, fatigue, sleep disruption, mood, and medications all interact to contribute to cognitive difficulties.
The encouraging message is that there are steps you can take, many alongside your existing arthritis treatment, to manage and potentially reduce brain fog. Tracking the pattern of cognitive “bad days,” sharing observations with your clinicians, aiming for optimal disease control, and protecting sleep, mood, and brain health are all part of the strategy.
If brain fog is disrupting your daily life, you don’t have to just live with it quietly. Bring it up with your rheumatologist or GP; awareness and open communication are the first steps toward better care.
This article is for general information and does not replace medical advice. Always consult your rheumatology or medical team before making changes to medication or treatment plans.
