Balance Problems

Feeling dizzy, unsteady, or lightheaded? These are common signs of balance problems. You might feel like the room is spinning or that you're about to fall, whether you're sitting, standing, or even lying down.

Good balance depends on many parts of your body working together smoothly. This includes your muscles, bones, joints, eyes, the part of your inner ear that helps with balance (called the vestibular system), nerves, heart, and blood vessels. If any of these systems aren't working properly, it can lead to balance problems.

Lots of different health issues can cause balance problems. In many cases, however, the problem is with the part of your inner ear responsible for balance. This is often called the vestibular system.

Problems with balance can show up in many ways. Common signs include:

• Feeling like you're spinning or moving (vertigo): This is a sensation of motion even when you're still. It can feel like the room is spinning around you.

• Feeling lightheaded or about to faint (presyncope): This means you feel weak, dizzy, and might pass out.

• Trouble keeping your balance or feeling unsteady: This can make it hard to stand or walk without wobbling.

• Falling or feeling like you're going to fall: This is a serious symptom that needs immediate attention.

• Feeling like you're floating or dizzy: This is a general feeling of disorientation and can be accompanied by other symptoms.

• Changes in vision, like blurry or double vision: Problems with your balance can sometimes affect how you see.

• Confusion or disorientation: This can make it hard to think clearly or understand your surroundings.

These are just some of the ways balance problems can manifest. If you experience any of these symptoms, it's important to see a doctor to find out the cause and get appropriate treatment.

Different medical conditions can cause problems with balance and dizziness. The specific cause is often linked to the symptoms you're experiencing.

Vertigo (a spinning sensation): Vertigo can have several causes:

• Benign Paroxysmal Positional Vertigo (BPPV): This is the most common type of vertigo in adults. BPPV happens when tiny crystals in your inner ear, which help you maintain balance, shift from their usual place. This shift can cause a spinning sensation when you change positions, like tilting your head or turning over in bed.

• Vestibular Neuritis: This is an inflammation of the nerves in your inner ear that control balance. It's often caused by a virus. Symptoms include severe and persistent dizziness, nausea, and trouble walking. These symptoms usually get better over several days without treatment.

• Persistent Postural-Perceptual Dizziness: This often occurs alongside other types of dizziness and is characterized by a feeling of unsteadiness or motion in your head. The symptoms can worsen when you look at moving things, read, or are in crowded or busy environments.

• Ménière's Disease: This rare condition typically affects people between 20 and 40 years old. Along with sudden, severe vertigo, it can cause fluctuating hearing loss and buzzing, ringing, or fullness in the ears. The exact cause is unknown.

• Migraine: Some migraines can cause dizziness and a sensitivity to movement (vestibular migraine). This is a common cause of dizziness.

• Acoustic Neuroma: This is a non-cancerous tumor that grows slowly on a nerve that controls hearing and balance. While dizziness can occur, hearing loss and ringing in the ear are more common symptoms. It's a rare condition.

• Ramsay Hunt Syndrome: This is a viral infection that can affect the facial, hearing, and balance nerves near the ear. Symptoms include vertigo, ear pain, facial weakness, and hearing loss.

• Head Injury: A concussion or other head injury can cause vertigo.

• Motion Sickness: Dizziness can occur while traveling in cars, boats, planes, or on amusement park rides. This is common, especially in people who have migraines.

Lightheadedness: Lightheadedness can be caused by a variety of factors:

• Cardiovascular Issues: Problems with your heart's rhythm, narrowed blood vessels, a thickened heart muscle, or low blood volume can reduce blood flow, leading to lightheadedness or fainting.

Loss of Balance (while walking): Problems with balance while walking can stem from:

• Vestibular Problems: Inner ear issues can cause a feeling of a floating or heavy head, and instability, especially in low-light conditions.

• Peripheral Neuropathy: Damage to the nerves in your legs can make it difficult to walk.

• Joint, Muscle, or Vision Problems: Weak muscles, unstable joints, or vision problems can contribute to balance issues.

• Medications: Some medications can cause loss of balance as a side effect.

• Neurological Conditions: Conditions like cervical spondylosis (a neck problem) and Parkinson's disease can affect balance.

General Dizziness/Lightheadedness:

• Inner Ear Problems: Issues with the part of your inner ear that controls balance can lead to dizziness and a sensation of floating or unusual movement.

• Hyperventilation: Rapid breathing, often associated with anxiety, can cause lightheadedness.

• Medications: Some medications can cause lightheadedness as a side effect.

It's important to remember that this is not an exhaustive list, and if you're experiencing dizziness or balance problems, it's crucial to consult a doctor for a proper diagnosis and treatment plan.

Doctors use various tests to diagnose balance problems. These tests help pinpoint the cause of dizziness, unsteadiness, or other balance issues.

Visual Tests: One test, called posturography, uses a virtual reality system. Imagine a moving image projected around you while you stand. The equipment tracks how you adjust your body to stay upright as the image moves. This helps doctors see which parts of your balance system are working the hardest.

Movement-Based Tests: Another common test is the rotary chair test. You sit in a special chair that slowly spins. Doctors observe your eye movements as the chair turns. This helps identify problems with the inner ear's role in balance.

Your Doctor's Initial Steps: Before any tests, your doctor will first review your medical history and do a physical exam. They'll check your reflexes, nerves, and overall health. This initial assessment helps them decide which tests are most appropriate.

Common Balance Function Tests: To find out if problems in your inner ear might be the cause, your doctor might recommend these tests:

• Hearing Tests: Balance and hearing are closely related. Problems with hearing can often affect balance. Your doctor will check your ability to hear different sounds.

• Posturography (Moving Platform): You'll wear a safety harness while standing on a platform that moves. The test measures how you adjust your body to stay balanced on the moving surface. This shows which parts of your balance system are most important for you.

• Eye Movement Tests (Electronystagmography & Videonystagmography): Your eye movements are recorded. Electronystagmography uses small sensors attached to your skin to track your eyes. Videonystagmography uses small cameras to do the same thing. These tests assess how your eyes and inner ear work together to maintain balance.

• Rotary Chair Test (Spinning Chair): As mentioned, this test involves sitting in a chair that spins. Your eye movements are carefully monitored as the chair moves. This helps to identify issues with your inner ear's balance function.

• Dix-Hallpike Maneuver: Your doctor gently moves your head into specific positions. This maneuver helps them check for a condition called benign paroxysmal positional vertigo (BPPV), which causes brief episodes of dizziness. They look for specific eye movements that might indicate BPPV.

• Vestibular Evoked Myogenic Potentials (VEMP): Sensors are placed on your head and neck. Sounds are played, and the sensors detect tiny changes in muscle contractions. This test helps identify problems in the inner ear's connection to the muscles that support your head.

• Imaging Tests (MRI & CT Scans): If other tests don't reveal the cause of your balance problems, your doctor might order an MRI or CT scan. These scans can help find underlying medical conditions that might be affecting your balance.

These tests help doctors understand the cause of your balance issues and create a treatment plan. Remember, it's important to discuss any concerns about your balance with a healthcare professional.