Pain and Cognition
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:
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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).
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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
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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).
- Repeat

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.