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Balance Problems Frequently Asked Questions

1. What is a balance disorder?

A balance disorder is a disturbance of the inner ear that can make people feel unsteady or as if they were moving, spinning, or floating. Balance disorders are one cause of falls and fall-related injuries, such as hip fracture.

2. How common are balance disorders?

Roughly 9 percent of adults who are 65 and older report having problems with balance. Experts believe that more than 40 percent of Americans will experience dizziness that is serious enough to go to a doctor.

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 that occurs 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 in the morning, or when looking up for an object on a high shelf. In BPPV, small calcium stones in the inner ear become displaced, causing a person to feel dizzy. The cause of BPPV is not known, although it may result from an inner ear infection, head injury, or aging.

Another type of balance disorder is labyrinthitis. This is an infection or inflammation of the inner ear causing dizziness and loss of balance. The labyrinth is an organ of the inner ear that helps you maintain your balance.

Ménière's disease is a balance disorder that causes a person to experience

• vertigo
• hearing loss that comes and goes
• tinnitus, which is a ringing or roaring in the ears
• a feeling of fullness in the ear.

It affects 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 one 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 and fall-related injuries, such as hip fracture, are the leading cause of death and disability for older adults.

6. What are some causes of 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, often through an ear infection such as otitis media, dizziness and loss of balance can occur. This condition is called labyrinthitis. Upper respiratory infections and other viral infections as well as stress, fatigue, allergies, smoking, or alcohol use also can lead to labyrinthitis.

7. Can medications cause balance problems?

Yes. Some medicines, such as those used to lower blood pressure, can make a person feel dizzy. Ototoxic drugs are medicines that damage the inner ear. Some antibiotics are ototoxic. If your medicine is ototoxic, you may feel off balance. 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, high blood pressure, diabetes, and heart disease increase the risk of stroke. Low blood pressure also can cause dizziness to occur.

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. Ménière's disease is linked to a change in the volume of fluid in the inner ear. By eating low-salt or salt-free foods, and steering clear of caffeine and alcohol, you can make its symptoms, such as vertigo, less severe. Balance problems due to high blood pressure can be managed by eating less sodium, maintaining a healthy weight, and exercising.

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, get a flu shot every year to stave off respiratory infections. If you still get an ear infection, see a doctor immediately before it becomes more serious.

11. If my medication is causing me to have 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 medicine 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.

Write down answers to these questions for your doctor:

• What medicines do you take? Remember to include all over-the-counter medicines, including aspirin, antihistamines, or sleep aids.
• What is the name of the medicine?

Write down answers to these questions for your doctor:

• How much medication do you take each day?
• What times of the day do you take the medicine?
• What is the health condition for which you take the medicine?

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 medicines 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 BPPV?

In benign paroxysmal positional vertigo, or BPPV, small calcium stones in the inner ear become displaced, causing a person to feel dizzy. An otolaryngologist can treat BPPV by carefully moving the head and torso to dislodge these stones.

18. What treatments are available for Ménière's disease?

Ménière's disease is caused by changes in fluid volumes in the inner ear. People with Ménière's disease can help reduce its dizzying effects by lowering the amount of sodium in their diets. Limiting alcohol or caffeine also may be helpful.

Some antibiotics, such as gentamicin, also are used to treat Ménière's disease. Although these antibiotics can help reduce the dizziness, they can also result in permanent hearing loss.

19. What research is being done to help treat and prevent balance disorders?

Scientists are working to understand the complex interactions between the part of the inner ear responsible for balance and the brain. They are also studying the effectiveness of certain exercises as a treatment option for balance disorders.

In 1998, Senator John Glenn, who was 77 years old at the time, took part in a study sponsored by the National Institute on Deafness and Other Communication Disorders, the National Institute on Aging, and NASA on how well a person recovers balance after returning from the weightlessness of space.

Data collected during the mission may help explain how a person recovers from a balance disorder. It also may help researchers develop ways to prevent injury from balance-related falls as people grow older.