Frequently Asked Questions about Balance Problems
1. What is a balance disorder?
A balance disorder is a disturbance of the body systems controlling balance. This disturbance can make people feel dizzy, unsteady, or as if they were spinning. Balance disorders are a common cause of falls and fall-related injuries, such as hip fractures.
2. How common are balance disorders?
In 2008, an estimated 14.8 percent of American adults (33.4 million) had a balance or dizziness problem during the past year.
3. Why is it important to have good balance?
Having good balance means you are able to control and maintain your body's position, whether you are moving or still. An intact sense of balance helps you walk without staggering, get up from a chair without falling, and climb stairs without tripping.
Good balance is important to help you get around, stay independent, and carry out daily activities.
4. What types of balance disorders are there?
There are many types of balance disorders. One of the most common among older adults is benign paroxysmal positional vertigo or BPPV. With BPPV, you experience a brief, intense feeling of vertigo when you change the position of your head.
You may also experience BPPV when rolling over to the left or right upon getting out of bed, or when looking up for an object on a high shelf. In BPPV, small calcium particles in the inner ear become displaced, causing dizziness. The reason the particles get displaced is not known, although it may result from an inner ear infection, head injury, or aging.
Another type of balance disorder is labyrinthitis. The labyrinth is an organ of the inner ear that helps you maintain your balance. When the labyrinth becomes infected or swollen, It is typically accompanied by vertigo and imbalance.
Upper respiratory infections and other viral infections, and, less commonly, bacterial infections, can lead to labyrinthitis.
Meniere's disease is a balance disorder that causes
- hearing loss that comes and goes
- tinnitus, which is a ringing or roaring in the ears
- a feeling of fullness in the ear.
Meniere's disease can affect adults of any age. The cause is unknown.
5. How can balance disorders affect an older person?
Balance disorders can have a serious impact on an older person's life. They are a common reason older people fall. A fall or a life of limited physical activity due to balance disorders can lead to health problems, isolation, and loss of independence.
Falls are the leading cause of are the leading cause of injury and death in older adults.
6. What causes balance disorders?
Some balance disorders are caused by problems in the inner ear. Others may involve another part of the body, such as the brain or the heart. Aging, infections, head injury, certain medicines, or problems with blood circulation may result in a balance problem.
The part of the inner ear that is responsible for balance is the labyrinth. When the labyrinth becomes infected or swollen this condition is called labyrinthitis.
Upper respiratory infections, other viral infections, and, less commonly, bacterial infections, can lead to labyrinthitis.
7. Can medications cause balance problems?
Yes. Some medications, such as those used to lower blood pressure, can make you feel dizzy. Other medications might damage the inner ear. These medications are called ototoxic. Some antibiotics are ototoxic. Check with your doctor if you notice a problem while taking a medication.
8. Are there conditions or diseases that can cause balance problems?
Yes. Diseases of the circulatory system, such as stroke, can cause dizziness and other balance problems. Smoking and diabetes can increase the risk of stroke. Low blood pressure also can cause dizziness.
9. What can I do to better protect myself from getting a balance disorder?
Your diet and lifestyle can help you manage certain balance-related problems. Meniere's disease is linked to a change in the volume of fluid in the inner ear. By eating low-salt (low-sodium) or salt-free foods, and steering clear of caffeine and alcohol, you can make symptoms such as vertigo less severe.
Balance problems due to high blood pressure can be managed by eating less less salt (sodium), maintaining a healthy weight, and exercising. Balance problems due to low blood pressure may be managed by drinking plenty of fluids, such as water, avoiding alcohol, and being cautious regarding your body's posture and movement, such as standing up slowly and avoiding crossing your legs when you’re seated.
10. How can I prevent infections that cause balance problems?
An ear infection called otitis media can cause balance problems. Otitis media is most common in children, but adults can get it, too. You can help prevent otitis media by washing your hands frequently. Also, talk to your doctor about getting a yearly flu shot to stave off flu-related ear infections. If you do get an ear infection, see a doctor immediately before it becomes more serious.
11. If my medication is causing a balance problem, what should I do?
If you take medication, ask your doctor if your medicine is ototoxic, or damaging to the ear. Ask if other drugs can be used instead. If not, ask if the dose can be safely reduced. Sometimes it cannot. However, your doctor will help you get the medication you need while trying to reduce unwanted side effects.
12. How do I know if I might have a balance problem?
Ask yourself the following questions. If you answer "yes" to any of these questions, you should discuss the symptom with your doctor.
- Do I feel unsteady?
- Do I feel as if the room is spinning around me?
- Do I feel as if I'm moving when I know I'm standing or sitting still?
- Do I lose my balance and fall?
- Do I feel as if I'm falling?
- Do I feel lightheaded or as if I might faint?
- Does my vision become blurred?
- Do I ever feel disoriented, losing my sense of time, place, or identity?
13. What do I do if I think I have a balance disorder?
If you think that you have a balance disorder, you should schedule an appointment with your family doctor. Your doctor may refer you to an otolaryngologist. This doctor and surgeon has special training in problems of the ear, nose, throat, head, and neck.
An otolaryngologist may ask you for your medical history and perform a physical examination to help figure out the possible causes of the balance disorder. He or she may also perform tests to determine the cause and extent of the problem.
14. How can I best talk to my doctor about a balance problem?
You can help your doctor make a diagnosis by writing down key information about your dizziness or balance problem beforehand and giving the information to your doctor during the visit.
Write down answers to these questions for your doctor:
- How would you describe your dizziness or balance problem?
- How often do you have dizziness or balance problems?
- Have you ever fallen?
- If so, when did you fall, where did you fall, and how often have you fallen? Tell your doctor as much as you can.
- What medications do you take? Remember to include all over-the-counter medicines, including aspirin, antihistamines, or sleep aids.
- What is the name of the medication?
- How much medication do you take each day?
- What times of the day do you take the medication?
- What is the health condition for which you take the medication?
15. What options do I have for treating a balance disorder?
Balance disorders can be signs of other health problems, such as an ear infection, stroke, or multiple sclerosis. In some cases, you can help treat a balance disorder by seeking medical treatment for the illness that is causing the disorder. Exercises, a change in diet, and some medications also can help treat a balance disorder.
16. How can exercise help with a balance disorder?
Some exercises help make up for a balance disorder by moving the head and body in certain ways. The exercises are developed especially for a patient by a professional who understands the balance system and its relationship with other systems in the body.
17. What treatments are available for benign paroxysmal positional vertigo (BPPV)?
In benign paroxysmal positional vertigo, or BPPV, small calcium particles in the inner ear become displaced, causing dizziness. A doctor or otolaryngologist can treat BPPV by carefully moving the head and torso to dislodge these particles.
An NIDCD-supported clinical trial in BPPV showed that repositioning maneuvers work well, and offered clinicians a range of choices in selecting the treatment best suited to each individual’s unique needs.
18. What treatments are available for Meniere's disease?
Meniere's disease is caused by changes in fluid volumes in the inner ear. People with Meniere's disease can help reduce its dizzying effects by lowering the amount of salt (sodium) in their diets. Limiting alcohol or caffeine also may be helpful.
Some medications, such as corticosteroids or the antibiotic gentamicin, also are used to treat Meniere's disease. Although gentamicin can help reduce the dizziness that occurs with Meniere's disease, it occasionally destroys sensory cells in the inner ear which can result in permanent hearing loss. Corticosteroids don't cause hearing loss; however, research is underway to determine if they are as effective as gentamicin
19. What research is being done to help treat and prevent balance disorders?
Scientists are working to understand the complex interactions between the brain and the part of the inner ear responsible for balance. They are also studying the effectiveness of certain exercises as a treatment option for balance disorders.
An NIDCD-supported clinical trial in benign paroxysmal positioning vertigo (BPPV) showed that repositioning maneuvers work well, and offered clinicians a range of choices in selecting the treatment best suited to each individual’s unique needs.
NIDCD-funded researchers have created a “virtual reality” grocery store. This virtual store is a computer-simulated environment that seems to be a physical place in the real world. It is designed so people with balance disorders can safely walk on a treadmill as they practice looking for items on store shelves. The goal is to help reduce a person's dizziness in confusing environments.
NIDCD-supported scientists are also studying the use of a vestibular implant to stop a Meniere's attack by restoring normal electrical activity in the vestibular nerve. This nerve conveys balance information to the brain. The device uses the same technology found in a cochlear implant, a medical device that currently provides a sense of sound to people who are deaf or hard-of-hearing.