Pain and Cognition


  • Cognition includes everything to do with thinking: memory, attention, problem solving, decision making, and learning
  • It can be conscious or subconscious- it includes acquiring knowledge, reasoning, perceiving
  • People with persistent pain often report loss of concentration, memory and attention difficulties
  • Anxiety, stress, depression, pain intensity and duration can affect cognitive function

In this module you will learn about: 

  • How pain affects cognition
  • The relationship between pain, cognition, and sleep
  • Mental fatigue/brain fog
  • How to manage brain fog and improve memory and concentration 


Chronic pain can impact your cognition

  • 54% people with chronic pain have problems with attention and memory
    • this can be related to sleep problems, medication side effects
  •  60% of people with chronic pain struggle with tests of attention – speed of response slowed
  • Chronic pain often impacts sleep- poor sleep has a huge impact on cognitive processes like attention and memory, as well as pain
    • Non-restorative sleep and fatigue, and cognitive dysfunction, are common symptoms of fibromyalgia (though are common in other pain conditions)



Brain fatigue/mental fog can make it harder to:

  • Pay attention, focus on a task, or concentrate
  • Remember things
  • Multi-task
  • Keep your train of thought while talking
  • Find the right words during a conversation
  • Work with numbers
  • Do tasks in the same amount of time as you used to
  • Recall details like names and dates
  • Understand the information you get
  • Make decisions and plans
  • Solve problems


Strategies to manage brain fatigue

Research has found that certain activities may help to reduce mental fatigue. These include: 

  • Restorative activities

    Restorative activities should:

    • Be enjoyable and attention-grabbing.
    • Take place in a peaceful or natural setting, or somewhere that allows the mind to rest but not sleep.
    • Involve a change from everyday activities and take your mind off of other concerns.
    • Be a change from daily routines and concerns (but not activities with a screen- these tend to take away mental energy!)
    • Be fun for you (for example, gardening may be fun and restorative to one person but not to another person).
  • Strategies for attention and focus

    • Find a quiet location with no distractions
    • Change your environment to prevent distraction, such as using ear plugs or comfortable seating
    • Do one thing at a time – don’t multitask!
    • Take mental breaks before you lose focus – plan ahead
    • “Brain work-outs” using computerized training programs
      • There is some evidence that they may work to help increase cognitive skills, but we don’t know if those skill transfer to usual activities
  • Strategies for memory

    - Compensate for, or cope with, memory problems  by using tools like apps, planners, and alarms to help you remember

    - Work on training your memory with games and tasks that test your memory. These include: 

    • Repeat
      • Repeat what you want to learn over and over again.
      • You can do this by saying it out loud, writing it down, or both. Repeat it over longer and longer periods of time.
      • This method can help you remember one thing. It will not improve your memory in general.
    • Screen out
      • Try to screen out or ignore information that you don’t need.
    • Group
      • Think about how different items connect. Then group them together.
      • To remember what to get from the store, group items by type (for example, cheese, milk and butter could go together, and fruits and vegetables could go together.)
    • First letter
      • Remember the first letter of the words you want to remember.
      • You can also make up a new word from these letters. For example, to remember the names of 4 people at work (Lee, Ali, Maria and Paul) you can use the word LAMP.
    • Rhyme
      • Use a rhyme or tune to remember a fact.- “I before E except after C,” “30 days has September, April, June and November”
    • Story
      • Make up a story using the facts you need to remember.
    • Picture it
      • Picture the object you want to remember. If you want to remember a person’s name try to connect their name to their face.
      • You can also picture an object that makes you think of that person (a teapot for someone who loves tea, or a bow tie for someone who always wears them).

Key concepts:

  • Next time you are having an important conversation with someone, pick a strategy to help you focus and remember the key points!
  • Practice is important!
  • You can even write things down when they are really important (even as a note on your phone) so that you can look them up next time you need to remember. 

76 Grenville St. Toronto, ON M5S 1B2 Canada

TAPMI Hub Clinic

Phone: 416-323-6269 Office Fax: 416-323-2666 Hours: 8:00 a.m. – 4:00 p.m. Monday – Friday


Dr. Tania Di Renna, Medical Director Sandra Robinson, Administrative Director