Balance Problems: Types, Causes, and Symptoms

Reviewed by Dr. Porter on January 16, 2021

When you have trouble maintaining your balance, the whole world becomes an obstacle course.

Stepping off a curb becomes an opportunity for an accident. The bottom step of the staircase or the landing of an escalator become a fall hazard. Simply standing up from a chair or rolling over in bed can make you dizzy.

Better balance leads to a better life. In this article, we will be discussing what balance problems are, some of the most common balance issues, what causes them, what to be on the lookout for if you think you may have a balance issue, and how Harbor Audiology can help.

What is a Balance Problem?

Everybody has a dizzy spell now and then. However, some people have issues with dizziness so often that they have a medically diagnosable problem.

A balance problem is a medical issue that makes you feel dizzy or unsteady, or that causes you to lose your balance. You might feel as if you are about to tip over as you are walking, or you might even fall flat on your face for no discernible reason. If you are stationary, standing, sitting, or lying down, you may feel as though you are spinning, moving, floating, or turning.

About 15 percent of Americans — that’s about 50 million people — have a balance problem. What are the symptoms that will tell you that you may have this problem?

On more than one occasion, you experience:

  • A spinning sensation of dizziness or vertigo
  • Falling, or having to catch yourself before you fall
  • Staggering as you walk
  • Faintness, a floating sensation, or lightheadedness

Balance problems can also be accompanied by:

  • Blurry vision
  • Feeling disoriented or confused

Some of the medical issues that cause these problems can also cause nausea, vomiting, diarrhea, changes in heart rate, changes in blood pressure, and anxiety. Failure to get help with these problems can change your life in ways that may even lead to depression and social isolation. It’s important to get a professional diagnosis and treatment for these issues.

lost balance

Common Balance Issues

Probably the most common related issue among North Americans is benign paroxysmal positional vertigo. This medical term just refers to quickly feeling dizzy when you change positions. About 20 percent of people who go to a doctor for treatment of these problems are found to have this condition.

Doctors typically define benign paroxysmal positional vertigo as dizziness that is provoked by certain movements. These movements cause nystagmus, which is quick, repetitive movements of the eyes. Attacks usually last 20 seconds or less, and repeating the problem movement in a test session causes a smaller response each time. Dizziness stops when people who have this condition return to the upright position.

Many people who have this condition just wake up one morning and feel dizzy when they try to sit up in bed. In the worst cases, the slightest head movements can trigger nausea and vomiting. In a few cases, patients are relatively unfazed.

Orthostatic hypotension is a condition that causes people to feel dizzy when moving from lying down to sitting up or standing up. It can also occur when moving from a seated position to a standing position. It’s related to blood pressure that is too low, and it’s most common in people who have just started taking a diuretic for blood pressure control.

Meniere’s disease is syndrome that has several well-defined symptoms. A little like migraine, people who are about to have an attack of Meniere’s disease will experience an “aura”. Unlike migraine, this aura is something you hear, or rather something you don’t hear, instead of something you see. The aura of Meniere’s disease consists of a roaring sound (tinnitus), a feeling of pressure in one ear, and/or hearing loss in the opposite ear. The roaring heard in the ear will usually get louder and louder until the episode starts to pass.

Some people who have Meniere’s disease won’t hear the roaring sound just before an attack but they will have the sensation of pressure in one ear and loss of hearing.

At least in the early stages of the disease, symptoms usually occur in one ear, not both.

After the aura, Meniere’s disease causes a sensation of spinning even though you are standing, sitting, or lying still. The spinning sensation usually lasts for about 20 minutes and slowly goes away.

A rare but frightening symptom of Meniere’s disease is the “drop attack.” It causes a sudden fall to the ground. Pedestrians may fall on their heads and suffer head injuries, and drivers may not be able to control the brakes or the accelerator.

Labyrinthitis results in many of the same symptoms as Meniere’s disease: dizziness, hearing loss usually in just one ear, a feeling of fullness in just one ear, and tinnitus producing a roaring sound. However, labyrinthitis also can cause earache, fever, neck stiffness, facial weakness, lopsided expressions on the face, and changes in vision.

Neurological diseases like Parkinson’s disease and multiple sclerosis can also cause balance problems, along with other mobility issues. Balance problems can also result from alcohol consumption or dehydration, and may be a complication of colds, flu, allergies, or sinus problems.


Causes of Balance Issues

Benign paroxysmal positional vertigo results from canalithiasis, which is best explained as “ear canal crystals”. Particles form in the ear canal that move around when someone who has the disease gets up from lying down, interfering with balance. The condition can also be caused by cupulolithiasis, an accumulation of particles in the cupula, the part of the ear that is directly responsible for balance.

There are surgical treatments for severe cases of benign paroxysmal positional vertigo, but your audiologist can offer you a non-invasive approach. Your audiologist can show you exercises or maneuvers that can aid in the reduction of vertigo by repositioning the ear crystals.

Orthostatic hypotension results from fluid changes in the ear canal. If excessive medication reduces blood pressure too much, not enough blood reaches the ear canal to supply it with fluid. Diuretics for high blood pressure and other conditions can cause dehydration that also deprives the ear canal of fluid. Corrections to fluid issues usually alleviate orthostatic hypotension.

Orthostatic hypotension can also result from excessive alcohol consumption and dehydration. Your audiologist can quickly determine whether you just need to change your drinking habits (less alcohol or more water) or your primary care provider needs to be consulted for a change in medication.

It’s not just blood pressure medications that can cause this problem.

The underlying cause of Meniere’s disease is a condition known as endolymphatic hydrops, or accumulation of fluid in the inner ear. There is a genetic component to the disease, but it seems to be triggered by trauma to the head (including ear surgery) as well as smoking, drinking, stress, and long-time use of aspirin. It usually starts between the ages of 20 and 50, so maturity may be a factor in the causes of the disease. However, the precise causes of this condition are not well understood currently.

Labyrinthitis results from infection of the inner ear. Bacterial infections may cause pressure on the ear canal and drainage from the outer opening of the ear. The bacteria that cause ear infections can also cause labyrinthitis. Similarly, any of a number of viral infections can also cause symptoms.

Neurological conditions like Parkinson’s disease and MS affect the way the brain interprets signals from the ears.

Symptoms to Watch Out For

The best time to get help for balance problems is before you have a serious incident that leads to you falling down the stairs, being incapable of getting out of bed, or losing consciousness while you are driving a car. Everyone should be tested by their audiologist every three to five years to make sure they aren’t having any hearing problems, and any kind of balance problem is a good reason to move up your appointment with your audiologist to get these problems checked out, too. If your small children seem to have these issues if you have ongoing problems with balance after a long plane ride or ocean voyage, or you just feel wobbly and don’t know why, make an appointment with your audiologist for an evaluation and treatment.

Harbor Audiology & Hearing Services Can Help

Harbor Audiology & Hearing Services Inc. has professional audiologists at locations throughout Western Washington ready to help patients of all ages with these problems. We specialize in helping veterans get the hearing and ear care services they need, and we take most kinds of insurance. Call Harbor Audiology at (253) 999-9649 or contact us online to connect to the help you need to live well with balance issues today!

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