women losing balance

What Causes a Lack of Balance?

Do you have a balance disorder?

A balance disorder is defined as a condition that makes you feel dizzy, or maybe you would say it makes you feel unsteady. Whether you are sitting, you are standing, or you are lying down, you may feel like the world is spinning around you or like you are floating in the air. You might feel OK when you are sitting down but dizzy when you stand up, or you might feel like you are about to tip over—or actually tip over—as you are walking.

Everybody has balance issues now and then. Dehydration, medication, and acute ear infections can bring on dizzy spells. If the problem lasts more than a few hours or begins to interfere with daily living, arranging a checkup with your audiologist is a good idea to determine what is causing it.

Balance problems are surprisingly common. Every year, a study by Dr. H. K. Neuhauser found that about one in five adults suffers a short-term, acute bout of balance problems. About a quarter of balance problems are caused by infections, inflammation, or injury in the inner ear. Since the COVID pandemic, balance problems have been reported in about a fifth of people who suffer from long COVID.


Symptoms of Balance Disorders

How can you know you are one of the 35 million Americans dealing with a balance disorder this year?

There is a well-known list of symptoms of balance disorders:

  • Spinning sensation (dizziness or vertigo).
  • Feeling as if you are about to fall.
  • Staggering when you walk.
  • Blurry vision.
  • The sensation that you are floating in air or water.
  • Lightheadedness, fainting, confusion.

There are also some lesser-known symptoms of balance disorders. The balance disorder may be mild enough that you don’t feel the symptoms listed above, but your brain has to work overtime to keep you balanced. This can leave you feeling vaguely anxious or mildly panicked. Your blood pressure may go up. Your heart may beat faster. You may experience bouts of nausea, vomiting, or diarrhea. Over time, these symptoms sap your energy, making you feel tired or depressed.


How Your Audiologist Tests for Balance Disorders

If you go to your primary care provider and let them know about the symptoms of the balance disorders we listed above, or if you go ahead and schedule an appointment with Harbor Audiology & Hearing Services, you will get some instructions for testing before you come in. Here is what you can expect.

Dizziness and balance testing with your audiologist is done so your doctors can know whether your dizziness is from an ear problem. Your doctor and audiologist will use this information to develop a diagnosis and some treatment options that will bring you symptomatic relief.

Balance testing will usually last 90 minutes to two hours. You will be asked to stand on your feet for part of the test. A part of the test will involve measuring your eye movements.

To get the best possible measurements from the test, your audiologist will send you instructions:

  • Don’t wear makeup on your face on your test day.
  • Wear loose and comfortable clothing.
  • You will also be asked to avoid certain medications, foods, and drinks for 24 hours before testing. You, your primary care provider, and your audiologist may have to work out how you will be able to skip certain medications for the test.

The first test you will usually undergo is the posturography test. In the posturography test, you will be asked to stand on a platform for 20 to 30 minutes while your audiologist measures how well you can keep your balance. You’ll be wearing a safety harness, so if you lose your balance at any time during the test, you won’t fall.

You may also be scheduled for the vamp test. In this test, you will lie back in a chair with your head to one side. There will be some stickers on your head and neck. There will be a headphone in one ear playing a loud clicking sound. All you have to do is to try to lift your head off the headrest while the clicking sound is playing.

Another part of your balance testing may be a videonystagmography (VNG) test. In this test, you will sit in a chair, wearing some goggles. You will be asked to follow a light from place to place on a virtual reality screen, and the goggles will measure your eye movements. In another part of the test, you will be asked to wear goggles and follow the light while lying back or turning your head to one side or the other.

In the last part of the VNG test, we will sometimes put some warm or cold water in your ears. This may cause dizziness, but it is useful for revealing whether your balance problems originate in your ears.

A few people who get motion sickness will experience nausea during their VNG testing. That is why we ask you to avoid eating for several hours before the test.

Finally, you may have a rotary chair test. This involves sitting in a chair in a small room in the dark as the chair slowly rotates from one side to the other. If you are claustrophobic, we will do everything possible to do the test quickly and keep you comfortable.

Your audiologist organizes the findings of this test. We may diagnose the cause of your balance issue or, in some cases, refer you back to your primary care provider or a specialist physician.


Harbor Audiology & Hearing Services Inc. is Here to Help

Harbor Audiology & Hearing Services serves patients from all over northwestern Washington. We do our best to accommodate your schedule and will work with your insurance company or medical benefits program to ensure you get all the benefits you are entitled to. Call or text us at (253) 999-9649 for further information or to make your appointment today!



Reviewed by Dr. Porter on May 25, 2023

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