Everyone experiences loss of balance at some point in their lives. However, loss of balance that occurs frequently can be a sign of an underlying health condition. It can also be a side effect of medication.
This article discusses symptoms associated with loss of balance, as well as potential causes and their treatment.
Symptoms of Loss of Balance
The most obvious symptom of loss of balance is falling, or feeling like you are about to fall. However, depending on the underlying cause, other symptoms can also occur with loss of balance, such as:
- Staggering while walking
- Feeling dizzy
- Sensation that the room is spinning (vertigo)
- Blurry vision
- Light-headedness
- Fainting
- Confusion
- Anxiety
- Nausea and/or vomiting
- Increased or decreased heart rate
- Increased of decreased blood pressure
- Diarrhea
What Causes Loss of Balance?
Maintaining balance requires three body systems to work together—vision, proprioception, and the vestibular system.
The visual system allows you to see where you are, and the obstacles around you. The proprioception system provides information about the position of your body through receptors in the joints of the body. The vestibular system is made up of structures in the inner ear and brain that process information about movements of the body.
Loss of balance can occur from conditions that affect any of these body systems. It can also be caused by muscle or nerve damage in the legs.
Balance issues can also be a side effect of certain medications.
Balance Disorders
There are many different balance disorders that cause ongoing loss of balance.
What Causes a Balance Problem, and What Can You Do About It?
Benign Paroxysmal Positional Vertigo (BPPV)
Benign paroxysmal positional vertigo (BPPV) is the most common inner ear condition that causes vertigo. It develops when calcium crystals in the ear (otoconia) move out of place. Symptoms come on suddenly with certain head movements.
In addition to loss of balance, BPPV can cause:
- Headaches
- Nausea
- Fainting
- Vomiting
BPPV is diagnosed using a technique called the Dix-Hallpike maneuver. This is performed by a healthcare provider and involves moving a person's body and head through a series of positions and observing the eyes for nystagmus (jerking movements).
BPPV is treated using a technique called the Epley maneuver, performed by a healthcare provider, which helps relocate the crystals to their proper position in the inner ear.
Ménière's Disease
Ménière's disease is a condition that is caused by buildup of fluid in the inner ear. This interferes with signals sent between the inner ear and the brain that help maintain balance.
Other symptoms of Ménière's disease include:
- Tinnitus (ringing in the ears)
- Pressure in the affected ear
- Difficulty hearing
Ménière's disease is diagnosed by a healthcare provider through a review of your symptoms. A hearing test might also be performed.
While there's no cure for this condition, symptoms can be treated with medications, dietary changes (limiting salt, caffeine, and alcohol), or injection of steroid medication.
Ear Inflammation or Infections
Inflammation or infections in the ear can lead to loss of balance. However, symptoms usually resolve once the inflammation or infection clears up, either on its own or with medication. These conditions are diagnosed with a physical exam of the inner ear using a device called an otoscope.
Two common examples are:
- Labyrinthitis: This type of inflammation or infection in the inner ear frequently occurs with upper respiratory medications.
- Vestibular neuronitis: This develops from inflammation of the vestibular nerve caused by a virus.
Neurological Conditions
Loss of balance is a common symptom of many different neurological conditions. Examples include:
- Multiple sclerosis
- Traumatic brain injury
- Parkinson's disease
- Brain tumor
- Cerebral palsy
- Guillain-Barré syndrome
- Stroke
- Spinal cord injury/compression
- Peripheral neuropathy
Diagnosing Neurological Conditions
Neurological conditions that can cause loss of balance are diagnosed through a variety of tests.
These can include:
- Neurological exam: In addition to loss of balance, this exam also assesses motor (movement) skills, hearing, speech, sensory skills, vision, and coordination.
- Blood, saliva, cerebral spinal fluid, and urine tests: The makeup of these bodily fluids can help healthcare providers determine underlying health conditions that affect balance.
- Computed tomography (CT) scan: This type of X-ray provides images of the brain and spinal cord to help detect tumors, or damage to these structures.
- Magnetic resonance imaging (MRI): This test uses powerful magnets to produce pictures of internal structures, such as the brain or spinal cord.
- Positron-emission tomography (PET) scan: This test involves injection of radioactive isotopes into the blood to assess the function of specific areas of the brain that are often affected with neurological conditions.
- Biopsy: This involves removing a small sample of tissue and examining it under a microscope to look for abnormalities.
- Angiography: During this procedure, dye is injected into blood vessels and X-rays are taken to look for blood clots or abnormalities in the vessels.
- Electromyography: This test helps diagnose muscle or nerve damage that can lead to loss of balance. Small needles are inserted into the muscle to measure electrical signals.
- Electroencephalography (EEG): Electrodes are attached to the scalp during this test to monitor brain activity.
Treatment of Neurological Conditions
Neurological conditions are treated with a variety of types of medications. These can include:
- Anti-seizure medication
- Blood thinners
- Immunotherapies
- Antidepressants
- Blood clot-busting drugs
- Dopaminergic drugs
- Corticosteroids
- Disease-modifying drugs
Physical therapy is commonly used to treat balance issues caused by neurological conditions. Interventions can include strengthening exercises, activities to improve proprioception, and instruction in the use of assistive devices (such as walkers or canes) to improve safety with walking.
In some cases, neurological conditions are also treated with radiation or surgery.
Loss of Balance Can Lead to Falls
Falling is a potentially dangerous side effect of loss of balance. Falls can lead to serious injuries, including broken bones or head injuries.
What Medications Can Cause Loss of Balance?
Loss of balance is a potential side effect of many medications.
Common types of drugs that can cause this symptom include:
- Blood pressure drugs, such as beta-blockers and angiotensin-converting emzyme (ACE) inhibitors
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids
- Sleep aids
- Antihistamines
- Antianxiety medications, such as benzodiazepines
- Anticholinergics
- Antispasmodics
- Diabetes medications, including insulin
- Heart medications, such as digoxin and anti-arrhythmics
See a healthcare provider if you are experiencing loss of balance on a regular basis. This symptom can make it unsafe for you to perform basic daily activities.
Summary
Loss of balance can be a symptom of an underlying health issue, such as a balance disorder affecting the inner ear, or a neurological condition. It can also be a side effect of certain drugs. Conditions that cause loss of balance are often treated with medications and physical therapy. Some might also require radiation or surgery.
A Word From Verywell
If you are experiencing frequent loss of balance, see your healthcare provider sooner than later. Early diagnosis of conditions that can cause this symptom typically leads to better outcomes. Addressing loss of balance proactively can also help prevent falls that can lead to serious injuries.
Frequently Asked Questions
What causes loss of balance?
Loss of balance can be caused by underlying health conditions that affect the inner ear, brain, spinal cord, muscles, or nerves. This symptom can also be a side effect of medications.
How can I improve my balance?
Balance issues sometimes resolve with treatment of the underlying cause. However, some conditions that cause loss of balance are not curable. Physical therapy can help improve balance with strengthening exercises, proprioception activities, and prescription of assistive devices (such as walkers or canes).
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Deafness and Other Communication Disorders. Balance disorders.
The Foundation for Peripheral Neuropathy. Maintaining balance.
Johns Hopkins Medicine. Benign paroxysmal positional vertigo (BPPV).
National Institute on Deafness and Other Communication Disorders. Ménière's disease.
National Institute of Neurological Disorders and Stroke. Neurological diagnostic tests and procedures fact sheet.
Harvard Health Publishing. How medications can affect your balance.
By Aubrey Bailey, PT, DPT, CHT
Dr, Bailey is a Virginia-based physical therapist and professor of anatomy and physiology with over a decade of experience.
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