Common Causes of Balance Problems

Taking your sense of balance for granted? You might be surprised how much sensorimotor effort goes into keeping you upright when walking, standing, and sitting. Balance problems can often negatively impact mobility and increase your risk of injury from falling. The ability to control your center of mass and adapt to balance shifts is key to your longevity.

Key players in your mechanical balance and postural control include:

• Vision - balance is actually a result of multiple inputs from your body, including the rods and cones in your eyes (sensory receptors) which convey to your brain visual cues regarding your position in space with those things around you (spatial orientation).

• Inner ear - sensory hair cells and endolymph fluid in your inner ear canal constantly respond to horizontal and vertical motion, helping your brain detect changes in your position relative to the pull of gravity.

• Muscles and joints - the feedback from your muscles and joints helps your brain stimulate limbs to evenly distribute your weight and keep you upright. Your skin also plays an important role in transmitting changes in the pressure or stretch over your tissues as you move.

Balance problems might include any of those which make you dizzy, unsteady, or physically unstable. If you experience a sense of spinning motion (vertigo), if you feel faint when standing or sitting, if you tip over when you stand or walk, or if you simply feel dizzy, you should see your healthcare provider about what might be causing your balance problems.

Oftentimes, balance problems can stem from:

• Vestibular issues - the vestibular, or inner ear, system responsible for your equilibrium is composed of the utricle and saccule, which detect linear movement as well as gravity, and three semicircular canals which identify rotational movement. Issues with any of part of this apparatus can disrupt your sense of balance. Vertigo is one of the most commonly known vestibular conditions and is marked by a spinning sensation of motion in your head, especially when tilting your head up.

• Vestibular neuritis is an inflammatory disorder which affects the nerves in your inner ear. Other vestibular conditions may include Ramsay Hunt syndrome where the shingles virus impairs the facial nerve near one of your ears, and benign paroxysmal positional vertigo (BPPV), where calcium crystals become dislodged and move around the inner ear.

• Meniere's disease - this rare condition typically affects adults between the ages of 20 and 60 and can lead to sudden dizziness, hearing loss, moderate to severe vertigo, a buzzing or ringing in the ears, or a feeling of pressure in the ear. An inner ear disease which largely affects online 1 ear, the root cause of Meniere’s is not currently known, and there is not yet a cure for it though treatments to lessen the severity of symptoms exist.

• Medicinal side effects - disequilibrium, lightheadedness, or dizziness can be side effects of certain medications including many used to treat blood pressure problems, depression and anxiety, cancer (i.e. chemotherapy), bacterial infections, and pain.

• Neurologic conditions - some neurological diseases like Parkinson’s and multiple sclerosis can negatively affect balance. With Parkinson’s, for example, damaged and dead neurons in the brain which are unable to produce dopamine can cause the motor cortex to malfunction as well as induce a muscle rigidity which challenges a patient’s postural stability.

• Chronic disease - other chronic conditions which affect heart and blood vessel health can cause balance problems associated with reduced blood flow, while diseases like diabetes can damage nerves in the feet and legs (peripheral neuropathy) and make balancing to stand and walk difficult.

• Aging process - even a healthy and normal aging process may be accompanied by joint inflexibility, loss of muscle strength, reduced reaction times, and impaired vision - all factors which contribute to balance and coordination issues. Adults over 65 have a 25% chance of experiencing a fall, often from a loss of balance.

Additional sources of balance problems include head trauma, motion sickness, low blood pressure (hypotension), and some psychiatric disorders. If balance problems, dizziness, faintness, or frequent falls are proving dangerous to your mobility and health, it’s important to talk to a doctor right away.

For older adults with balance problems, simple home upgrades can help keep you safe like a bed rail, fall mat, bath step, grab bars, and stair railings. Discussing medicine side effects, especially dizziness and faintness, can play an important role in maximizing your balance capabilities too.

In the cases where an underlying condition is causing your lack of stability, even if there isn’t a “cure,” there are often treatments available to help you stay active. These might include medicine, physical therapy, or mobility supports. Customized balance retraining (also called vestibular rehabilitation) may be helpful in educating someone with balance problems on how to compensate for lack of stability and maintain physical activity.

This is a guest blog entry.