Balance is maintained by a number of body systems, including the brain, nerves, eyes, ears, bones, and joints. If one or more of these is not working properly, you may feel dizzy and unsteady on your feet.
Often, dizziness is a temporary condition and can be corrected by medication or lifestyle changes. But some cases of balance problems may be a sign of a more serious problem.
Causes
Many things can cause a loss of balance, including problems with your inner ear, brain, or nerves. You can also experience unsteadiness if your muscles or joints are weak or damaged. Sometimes balance issues are a side effect of certain medications.
A problem with your inner ear can lead to vertigo or a feeling of spinning, which can also affect your spatial awareness. This may be caused by an infection, such as labyrinthitis or vestibular neuritis, or by an injury to the inner ear. These conditions can cause permanent hearing and balance problems, but they usually clear up on their own.
Head injuries can also disrupt the way your body senses movement and balance. This is because the impact can damage parts of your ear and the structures that send information about balance to your brain. The symptoms of these injuries can be mild to severe.
Other causes of balance problems include problems with your eyes or bones and some medications. For example, low blood pressure can make you feel dizzy and lightheaded. This can occur if you stand up quickly from sitting or lying down. You may also feel off balance if you take certain drugs, such as anticholinergics or monoamine oxidase inhibitors (MAOIs).
A hit to your head can interrupt the flow of information between your brain and your inner ear, causing you to feel off balance. This type of injury is called a traumatic brain injury or concussion. It can also interfere with the signals from your eyes to your brain, which control movements.
If you’re experiencing unsteadiness, your doctor can check for problems with your heart or nervous system that could be causing it. This includes a physical exam and questions about your medical history. Your doctor can also order blood, saliva, or cerebral spinal fluid tests to look for signs of an underlying health condition that affects your balance. They can also order a computed tomography (CT) scan or magnetic resonance imaging (MRI) to see images of your brain and spinal cord.
Diagnosis
Balance is a complex process involving the brain and spinal cord, inner ears, eyes, peripheral nerves, muscles, and bones. Most people with balance problems have a medical condition that causes them to lose their sense of balance and feel unsteady or like the room is spinning. It’s important to see a doctor if these symptoms persist.
Various conditions can cause loss of balance, including ear infections, head injuries, certain medications, and neurological disorders. Some of these conditions affect the signals the inner ear sends to the brain, which control our sense of balance and spatial awareness.
Balance disorder diagnosis typically begins with a physical exam and a review of the person’s symptoms. The doctor may order tests, such as an MRI or CT scan, to check the inner ear and other parts of the body that contribute to balance. Blood tests, eye exams, and an EKG may also be ordered to help diagnose some conditions.
For example, a person who experiences a sense of movement when he or she tilts the head back might have a condition called benign paroxysmal positional vertigo (BPPV). This condition occurs when calcium crystals in the inner ear get dislodged from their normal positions and move to another part of the inner ear, which triggers feelings of motion or spinning. BPPV can be triggered by a variety of activities, including lying down or turning your head to look up at something.
Medications can also contribute to balance problems by affecting the inner ear. If a person takes medication that causes balance issues, the doctor may change the dosage or switch the medicine.
Falling can be dangerous and lead to serious injuries, such as fractured bones or traumatic brain injury. If someone falls regularly, the doctor may prescribe medication to prevent falls or suggest using a cane or walker.
Physical therapy and balance training with a vestibular rehabilitation therapist can help people manage their balance problems. The therapist will teach patients exercises that strengthen the legs and core and ways to improve proprioception, which is the ability to sense where the body is in space. The therapist can also recommend home and work accommodations to reduce the risk of falls, such as installing handrails on stairs or in bathrooms.
Treatment
If you feel dizzy or unsteady, it could be a sign of a balance disorder. These problems affect the inner ear, the brain, or the nerves that control your legs and feet. They can be caused by certain health conditions, head injury, aging, infections, or medication. Some of these disorders cause short-term dizziness, while others can produce a sense of spinning that lasts for days or weeks.
Getting the right diagnosis is key to treatment. Your doctor will ask about your symptoms and examine you. He or she may also do a blood test or imaging tests of your ears and brain. Your doctor might do a simple test called the roll test, which involves lying on your back and moving your head to one side for a few minutes. This will help pinpoint the cause of your balance problem.
Some conditions, such as a traumatic head injury or a stroke, can cause temporary balance problems. These usually clear up on their own or with treatment. A “mini” stroke, called a transient ischemic attack, or TIA, can also cause balance issues along with other symptoms, such as weakness on one side of your body and trouble with speech. These can be treated with medications or surgery, if necessary.
Infections or inflammation of the inner ear can also cause balance problems. These include vestibular neuronitis and labyrinthitis. Vestibular neuronitis is a condition that develops when the vestibular nerve in your inner ear becomes inflamed. Labyrinthitis occurs when a virus infects the vestibular system in your inner ear.
You can reduce your risk of balance problems by staying hydrated, avoiding salt and caffeine, exercising regularly, and not smoking. You should also get regular medical checkups to catch any underlying illnesses, such as hearing loss or eye disease, before worsening.
In some cases, your doctor might recommend certain exercises and dietary changes to activate your balance system. Your doctor might also instruct you on how to use a cane or handrails when walking up or down stairs. He or she might also advise you to avoid activities that increase your risk of falling, such as driving.
Prevention
Everyone experiences a loss of balance from time to time, but when it occurs frequently, it may be a sign of an underlying health condition. The human body maintains balance through a complex interaction of many systems, including the eyes, muscles, and bones in the legs, nerves, and inner ears. Problems in any of these systems can disrupt the flow of information that keeps us steady.
When you lose your balance, the brain is getting conflicting signals from several sources, and it may not be able to process them quickly enough. This can lead to a feeling of unsteadiness or dizziness, nausea, and vomiting. If these symptoms persist, you should seek medical attention.
The most common causes of balance problems are problems in the inner ear, such as labyrinthitis (abnormality of the vestibular system, a maze-like structure within the inner ear that contains semicircular canals, fluid, and otolith organs that detect movement and gravity) or other ear infections, a cerebellar lesion in the brain, head trauma, traumatic brain injury, cervical spondylosis, Parkinson’s disease, or a neurological disorder. Medications, particularly ones that affect the inner ear or vision, can cause dizziness or imbalance.
Loss of balance can occur at any age, but it’s more common as people get older. This is partly because the many different parts of the body that keep us upright and stable have to work together cohesively, and more things can go wrong as we age.
Preventing balance problems depends on identifying and managing the underlying cause, which may require medications or physical therapy. It’s also important to stay active to improve balance and prevent falls, especially if you have an underlying condition that can lead to them. Exercises like tai chi, yoga, or standard strength training effectively improve balance and prevent falls.
It’s one thing to be a little klutzy — everybody has their Three Stooges moments — but falling is not a laughing matter, and it’s the number one cause of serious injury among seniors. Fall prevention strategies include wearing comfortable footwear, reducing household hazards, and using handrails on stairs.
