Mixing up names. Losing words. Struggling to concentrate. If you’ve experienced these issues, you may have heard them described as “brain fog.” This frustrating and sometimes distressing symptom affects some people with spondylitis and can happen for multiple reasons.

Members of MySpondylitisTeam have shared worries and frustrations about their cognitive issues — including difficulties with memory, focus, processing speed, and finding the right words — and how these challenges affect daily life. “My family says I’m going senile, but I know I am not. How does one explain brain fog?” asked one member.

Another said, “The worst part about brain fog, as with almost everything else associated with spondylitis, is trying to get people (employers, friends, family, etc.) to understand what you’re going through.”

Here’s what to know about brain fog in spondylitis, including what causes it and what health experts and members have recommended for managing life with a “fuzzy head.”

What Is Brain Fog?

In short, brain fog refers to mild cognitive impairment. It results in a whole host of cognitive issues, including forgetfulness, difficulty concentrating, and overall mental sluggishness.

Brain fog is not specifically a medical condition, but rather a symptom. It’s been connected to certain inflammatory conditions, including spondylitis, where an overactive immune system triggers inflammation that may affect the brain and prevent it from reaching a full state of alertness.

Many people associate forgetfulness and cognitive problems with serious medical conditions like dementia. So, experiencing brain fog can be unsettling, especially alongside a spondylitis diagnosis. However, brain fog is typically caused by other factors. As one member wrote, “I thought it was the beginning of dementia. Now I see it’s not. Spondylosis is the cause.”

What Does Brain Fog Feel Like?

Not everyone experiences brain fog in the same way. Some MySpondylitisTeam members report that they forget words. “Sometimes, my words don’t match what I’m thinking. Ugh! I didn’t know this goes along with spondylitis,” one member wrote.

Others find that they feel generally “fuzzy” or “out of it,” like one member who stated that they were “having brain fog and trouble concentrating.”

Confusion is another common experience with brain fog. “My 50th birthday was last year, and we went to the Chinese buffet. My daughter set it up for me, but I thought we went somewhere else! She had to give me hints. I said that it must be brain fog, but I still felt bad,” one member said.

The Impact of Brain Fog on People With Spondylitis

Brain fog can have a broad range of impacts on daily life. A small 2020 study published in the Canadian Journal of Neurological Sciences found more symptoms of cognitive impairment in people with ankylosing spondylitis (AS) compared to people without AS or any other condition. In particular, participants diagnosed with AS did poorly on tests related to verbal fluency (the ability to quickly recall and articulate words) and clock drawing — a common test used to screen for cognitive disorders.

Some MySpondylitisTeam members have said that their brain fog doesn’t just cause problems in their personal lives — it also impacts their professional lives.

• “My brain function has been so affected, I feel like my job is in jeopardy.”
• “This week at work was particularly hard. Not only could I not find the right words, but comprehension was so difficult that my boss emailed my co-workers, wanting to know what was wrong with me.”
• “I have to go back and edit things I write due to spelling errors.”

What Causes Brain Fog in Spondylitis?

The exact cause of brain fog isn’t fully understood, but several factors may contribute to cognitive difficulties in people with spondylitis.

Inflammation

If you’ve ever wondered if inflammation can cause brain fog, you’re not alone. One 2018 study linked chronic inflammation and cognitive dysfunction. Inflammation can also increase chronic pain and fatigue and cause sleep disturbances, all of which may contribute to cognitive fogginess.

Sleep Deprivation

Many people with AS struggle to get quality sleep due to intense back and joint pain. Sleep deprivation doesn’t just cause daytime fatigue — it has also been linked to cognitive issues such as reduced concentration and memory problems. Maintaining good sleep habits and managing pain effectively can help minimize these effects.

Amyloidosis

Amyloidosis is a condition where abnormal proteins build up in your tissues, and may affect your organs. Although rare, it can develop in people with poorly managed AS who have had the disease for more than 10 years. In some cases, amyloidosis in the brain can contribute to difficulties with concentration and memory.

Medications

Some MySpondylitisTeam members have found that their brain fog is connected to their medications. As one member wrote, “Using 1,200 milligrams of gabapentin (Neurontin) a day wiped out my memory big time.”

Gabapentin is a medication that may help with your back pain, but like any medication, it has its side effects, including dizziness and memory loss.

Although not so commonly used in AS, corticosteroids like prednisone, can sometimes affect cognition as well. Differentiating between medication- and spondylitis-related brain fog can be difficult. “Will this get worse with each shot or is it a side effect of spondylitis?” one member commented.

People with autoimmune diseases are at a higher risk of developing dyslipidemia (high cholesterol levels), due to ongoing inflammation. Some cholesterol-lowering drugs, called statins, have been linked to brain fog, but the connection remains uncertain. An article published by the Canadian Pharmacists Journal acknowledged that people have experienced brain fog symptoms after taking statins, but researchers found no direct link between the two.

Talk to your rheumatologist for their medical advice if you experience any side effects from your medication, whether it’s brain fog or a different, unexpected symptom. They will advise you on the best way of treating your spondylitis while minimizing side effects.

Managing Brain Fog With Spondylitis

Managing your brain fog may help improve your mental health, overall wellness, and quality of life. Different techniques are suitable for different people, but the MySpondylitisTeam community has come up with several unique ways to target this often debilitating symptom.

Following a Treatment Plan

Sticking to a treatment plan tailored to your lifestyle, health conditions, and disease activity can help reduce inflammation, slow disease progression, and improve symptoms — including brain fog.

Research suggests that biologic therapies, such as tumor necrosis factor (TNF) inhibitors, not only help manage AS but may also slow cognitive decline. Talk to your rheumatologist about treatment options that could support both your joint health and brain function.

Training Your Brain

How do members of MySpondylitisTeam “lift the fog?” One member plays word and puzzle games to keep their brain sharp. “I have to use logic with all of them, so it keeps my brain going,” they said.

Some research suggests that mentally stimulating activities, such as puzzles and word games, may help support cognitive function and lower the risk of cognitive decline. However, more studies are needed to confirm these benefits — especially for brain fog related to AS.

Engaging in Physical Activity

According to research from Columbia University, aerobic activity may improve cognitive function, particularly reasoning, problem-solving, and planning. One member uses hiking as their go-to physical activity for managing brain fog. “After the first hour, the brain fog lifts, and pains subside,” they reported.

Getting Organized

If brain fog makes it hard to remember appointments, deadlines, or daily tasks, creating a structured routine can help.

• Use a planner, diary, or scheduling app to track important dates.
• Hang a calendar in a visible place to keep reminders top of mind.
• Share your schedule with household members so they can help with gentle reminders.

Setting a Sleeping Schedule

Prioritizing good sleep habits can help reduce brain fog. Try these strategies for better rest:

• Keep a consistent bedtime and wake-up time (even on weekends).
• Avoid screens, bright lights, and loud noises before bed.
• Create a relaxing bedtime routine, such as reading or listening to calming music.

Since poor sleep is a major contributor to brain fog, improving sleep quality may help clear your mind and boost focus during the day.

Talk to Your Doctor

Brain fog can be a frustrating and disruptive symptom of spondylitis, but understanding its potential causes can help you take steps to manage it. If brain fog is affecting your daily life, talk to your rheumatologist. They can help determine whether your symptoms are related to spondylitis, medications, or another factor and work with you to find the best treatment plan to support both your physical and cognitive health.

Find Your Team

MySpondylitisTeam is the social network for people with spondylitis and their loved ones. On MySpondylitisTeam, more than 99,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.

Have you had brain fog? What are your techniques for handling this symptom? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.