Understanding brain fog in CRPS: causes, symptoms and management

Learn about how brain fog can affect those living with CRPS - why, how and what to do about it.

By Georgie Archer

What is CRPS?

Complex Regional Pain Syndrome (CRPS) is a neurological condition associated with imbalance and malfunction in the autonomic nervous system (ANS) which controls involuntary functions like blood pressure. CRPS can be triggered by damage to tissue, nerves, fractures, traumas, strokes and more. Its primary symptom is chronic pain, which can lead to loss of limb function and disability.

CRPS is a multi-system disorder characterised by severe pain, when both the nervous system and immune system malfunction, often in response to tissue damage. As well as causing physical symptoms in muscles, bones, blood, skin and organs (among other things), CRPS can cause psychological symptoms. These can include depression, anxiety and stress, sleeping problems/insomnia, post-traumatic stress disorder (PTSD) and brain fog.

Memory loss or brain fog is experienced by many people who suffer from CRPS. ‘Brain fog’ is often used to describe a range of symptoms including (but not limited to):

• Short term memory lossProblems with attention span
• Issues with verbal fluency/language impairment
• Impaired ‘executive function’ – which controls a person’s behaviour
• Directional disorientation
• Multi-tasking difficulties
• Confusion
• Difficulty with numbers

Some people with CRPS don’t suffer from brain fog at all, whilst for others it can be as debilitating as other symptoms of CRPS. The most prominent issue with brain fog is poor memory – one person with CRPS said he felt, at the age of 30, that he had the memory of an 80 year old.

The causes of brain fog are unclear. They could result from structural brain changes, or arise as a result of other symptomatic factors associated with CRPS.

Studies have shown that people with CRPS exhibit clear changes to the brain, including atrophy (weakening or reduction in size/strength) of the grey matter and connectivity in the white matter. This means that the outside of the brain may shrink, and the inside of the brain may experience connectivity changes. These areas of the brain affect the intensity and duration of pain. Impacts within the Autonomic Nervous System may affect all kinds of bodily systems.

Memory can be affected by other things, including lack of sleep and depression, both commonly suffered by those with CRPS and other chronic pain conditions. Poor memory is recognised as a side effect of many medications prescribed to those suffering from chronic pain including opioids, antispasmodics and NMDA receptor blockers. Memory loss could also arise from the Limbic System, the area of the brain that controls mood and instinct.

CRPS is also known to cause changes in the motor cortex, which is involved in voluntary movement. This is strong in patients with CRPS dystonia.

Although treatments are not specifically available for CRPS or those affected by chronic pain, people with CRPS who suffer from memory loss often overcome struggles and learn how to get rid of brain fog by:

• Noting down things throughout the day

• Engaging in activities that may help memory such as meditation, Yoga or Tai Chi

• Taking supplements to aid brain function, including Ginkgo Biloba, Magnesium and Citicoline

• Brain training – to encourage the natural healing ability of the brain

• Avoiding over-stimulation

• Getting outside

• Organising your life and environment to avoid chaos

• Eating regularly and healthily

It’s important with CRPS to pick your moment. Schedule important tasks for the hours you work best, using the Spoon Theory to establish and manage your energy expenditure.

Living with CRPS and brain fog can be challenging, but you’re not alone. It’s crucial to be kind to yourself and accept that some days will be better than others.