Most balance problems occur because of brain or inner ear problems, or physical issues, such as broken bones or muscle injuries.
Balance problems can make it difficult to walk or move. They may make a person feel like the room is spinning.
While many balance problems are relatively harmless, it is impossible for a person to diagnose the cause on their own.
People who experience trouble with balance and coordinating their movements should see a doctor if symptoms persist.
How does the sense of balance work?
The vestibular system is part of the inner ear. It provides information to the brain about the sense of balance and where the body is in space.
It also works together with the eyes and brain to make movement feel smooth and coordinated.
The vestibular system helps the brain coordinate numerous actions, including standing up, walking, reaching for objects, and knowing when the body is moving or not.
Symptoms of balance problems
Balance issues typically fall into one of two categories: physical injuries or neurological and inner ear issues.
A person with vertigo or other forms of dizziness may have trouble coordinating their movements. Their brain may not be sending the right signals, and they may feel like the room is spinning.
Physical injuries, in contrast, usually cause movement issues in specific areas of the body.
Neurological and inner ear issues
Problems with the nervous system, the inner ear, or the circulatory system can make it difficult to coordinate movement.
Some symptoms include feeling:
- dizzy
- confused about where the body is in space
- anxious about walking or moving
- like the room is spinning
- weakness or numbness on one side of the body
Physical injuries
Sometimes, a physical injury makes it difficult to move all or part of the body. Some symptoms include:
- muscle weakness that causes a person to fall easily
- pain when moving that makes it difficult to maintain balance
- a spinal cord injury that makes it difficult or impossible to move certain areas of the body
- strange sensations when moving
- feeling unsteady on the feet
Causes
Numerous factors can trigger a loss of balance.
Vertigo
Vertigo is a collection of symptoms, not a diagnosis.
It is common, with 20–30% of people experiencing symptoms at some point during their lives. It can cause people to feel like they are spinning or out of balance, which can lead to falls.
People with inner ear problems are more vulnerable to vertigo, as the inner ear is a key source of a person’s sense of balance.
One common trigger for vertigo is benign paroxysmal positional vertigo. According to Ménière’s Society, around 50% of all people will experience this condition at some point in their lives.
Another cause of vertigo is Ménière’s disease, a condition that affects the inner ear, inducing dizziness and hearing changes.
Vertigo can also occur when tiny crystals inside the inner ear move out of place, affecting balance. A doctor can help move them back where they were.
Brain injury
Brain injuries may affect balance and mobility.
People who suffer a traumatic brain injury or a concussion may have balance issues. These may present immediately after the injury or start weeks or months later.
Balance problems following a fall or car accident constitute a medical emergency. Seek medical help if a person is experiencing these.
The treatment depends on many factors, but physical therapy and occupational therapy often help.
Spinal cord injury
A spinal cord injury damages or severs the spinal cord. This makes it more difficult, and sometimes impossible, for the brain to send messages to the body.
Depending on the severity of the injury, this may cause balance and mobility problems, or may completely paralyze a person.
Treatment for spinal cord injury depends on the severity and location. Some injuries are not treatable or curable. Others may improve with surgery and physical rehabilitation.
Chronic medical conditions
Numerous chronic and progressive diseases may affect balance and coordination.
Multiple sclerosis is one of the most common. It occurs when the body attacks the protective covering of the nerves, causing progressive damage that can leave a person with severe mobility and balance issues.
Parkinson’s disease, which also progressively affects balance, may cause a person to fall, shake, or feel off-balance.
Amyotrophic lateral sclerosis (ALS), sometimes called Lou Gehrig’s disease, progressively damages nerve cells.
This makes voluntary movements, such as walking, more difficult. Balance problems may appear before other symptoms.
Treatment for chronic medical conditions vary. Most progressive disorders are not curable, but medication and rehabilitation may slow the disease.
Stroke
A stroke occurs when blood flow to the brain temporarily stops or slows, often due to a blood clot or bleed. This can damage brain tissue and interfere with the brain’s ability to communicate with the body.
Some people have problems with balance during or after a stroke.
A stroke requires prompt emergency medical care. A person should seek urgent medical help if they experience numbness on one side of the body, a drooping face, and similar stroke symptoms.
Removing the blockage may reduce the risk of long-term brain damage. To recover from a stroke, a person may need medication and physical therapy.
Migraine
A migraine is a neurological headache that may affect vision, cause nausea, or trigger unusual visual or auditory sensations.
Some people experience vestibular migraines. These headaches affect the vestibular system, which is responsible for balance.
Migraine medications may ease symptoms, while some people also find relief from lifestyle changes.
Age
It is common for balance to decline as a person ages.
While age does not inevitably trigger balance problems, many lifestyle and health factors may play a part.
As people age, they may become more sedentary as their muscle mass declines. This can make it difficult for them to walk, which may induce balance issues.
As a person ages, they may also find it more difficult to recover from injuries, which may aggravate preexisting balance issues.
Medication
Any medication that changes the way the brain functions can affect balance.
For example, sleeping medications may make people feel slower and sluggish, causing them to trip or feel dizzy.
Alcohol and drugs may also make it more difficult to walk or move without falling.
Almost any medicine can potentially trigger dizziness, though this is more common with certain drugs, including:
- alcohol and illegal drugs
- beta-blockers
- antianxiety medication
- some antibiotics
- antidepressants
- antipsychotic drugs
- sleeping pills
Sedentary lifestyle
A sedentary lifestyle on its own will not cause severe balance issues. However, people who are generally inactive may find they have trouble with balance.
This may be especially true for older people or those with other conditions that affect balance.
Balance is a skill that requires practice. Regular physical activity and balance exercises may help a person improve their coordination.
Physical injuries
Any physical injury can potentially affect balance, especially when it makes it more difficult to coordinate movement.
A person with good coordination may struggle to walk on crutches or a broken leg. Sometimes, injuries cause chronic pain or loss of strength, leading to longer-term balance problems.
Loss of balance while walking
People may lose their balance while walking if they trip, become distracted, or wear shoes that do not fit.
While everyone trips sometimes, it is not normal to frequently stumble or feel dizzy.
If a person finds they frequently lose balance while walking, they may consider talking to a doctor. They may have a balance disorder, such as a condition affecting the inner ear or brain.
Diagnosis
Diagnosing balance problems usually begins with looking at a person’s medical history. A doctor may also perform several tests, including:
- using balance tests to see how well a person moves
- performing bloodwork to test for infections
- examining injuries to see how they affect movement
- asking a person to keep a log of dizziness episodes
- ordering X-rays or other tests to look for injuries and broken bones
How to improve balance
A person can often improve their balance with home exercises and physical therapy.
Work with a doctor or physical therapist to determine which exercises are safe, especially if severe dizziness is a frequent issue.
When to see a doctor
It is normal to feel dizzy when sick, tired, drunk, or under the influence of certain medications. Some people also get dizzy when they are hungry or anxious.
However, chronic balance problems may indicate a serious medical condition. Prompt diagnosis and treatment can improve outcomes and, in some cases, may even save lives.
See a doctor if a person experiences:
- dizziness so severe that they cannot safely walk or drive
- dizziness that lasts for more than a few days
- periodic bouts of dizziness for no apparent reason
- other symptoms, such as confusion
Go to the emergency room if a person experiences dizziness after a fall or car accident, or if there are signs of a stroke, such as slurred speech or numbness on one side of the body.
Summary
Some people may find dizziness scary, and it can affect their quality of life. In most cases, it is possible to treat the cause to ease or eliminate symptoms of dizziness.
If a person has concerns about dizziness, they should talk to a doctor.
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