Finding Your Center: Three Underlying Causes of Balance Issues

Have you ever ridden a rollercoaster, had a bit too much to drink, or sailed over rough and choppy seas? If so, you may have experienced a temporary loss of balance—that woozy, room-spinning feeling that leaves you staggering and holding on to support until you regain your steadiness. While such episodes are typically fleeting and harmless, a persistent or frequent loss of balance could indicate an underlying medical issue that needs attention.

Balance problem is health-related

"Your ability to sit, stand, and walk without falling or swaying involves more than just your muscles and bones," explains Dr. Franco Louie L.B. Abes, an otorhinolaryngologist at Makati Medical Center in the Philippines. "These actions also involve your eyes, inner ear, nerves, heart, brain, muscles, and blood vessels. When one of these key components doesn't function as it should, it can impact your balance."

Health-related balance problems can originate from one of three primary sources: the vestibular system, the vascular system, and the nervous system.

The vestibular system is often associated with the inner ear. "Certain medications, ear infections, calcium crystals that move to the wrong side of the inner ear, excessive fluid in the inner ear (Meniere's disease), or a benign tumor in the ear (acoustic neuroma) can affect your balance," says Dr. Abes. Symptoms to watch for include dizziness, vertigo, unsteadiness, blurred vision, and even falling. These conditions disrupt the normal function of the inner ear, which plays a crucial role in maintaining equilibrium.

The vascular system controls the flow of blood to the brain. "Poor circulation, standing up or sitting down too quickly (orthostatic hypotension), and stroke can manifest as dizziness, lightheadedness, and a feeling of fainting," Dr. Abes explains. When blood flow to the brain is compromised, it can lead to insufficient oxygen and nutrient delivery, causing these unsettling symptoms.

The nervous system, comprising the brain, spinal cord, and other nerves, can also be the source of imbalance issues. "Conditions like Parkinson's disease, Alzheimer's disease, cervical spondylosis, multiple sclerosis, and the presence of an infarct or a concussion can result in a loss of balance," Dr. Abes points out. These neurological conditions can interfere with the brain's ability to process information and coordinate movements, leading to balance disturbances.

To diagnose the cause of a balance problem, a thorough clinical examination and further diagnostic tests are essential. "You should likely see an otolaryngologist, who specializes in diseases and disorders of the ear, nose, neck, and throat," says Dr. Abes. For instance, if your balance issue is due to dislodged crystals in your inner ear, the doctor may perform the Epley maneuver, which helps move the calcium crystals back into their proper place. Treatments like steroids and vestibular rehabilitation therapy can address inner ear infections and Meniere's disease.

If initial examinations and treatments do not resolve the problem, further evaluation with vestibular tests and imaging studies of the head and brain may be necessary. These advanced diagnostic tools can provide detailed information about the inner ear structures and the brain, helping to pinpoint the exact cause of the balance issue.

"The key is not to delay a consultation," advises Dr. Abes. "An unsteady gait doesn't just interfere with your daily activities. It could lead to more serious problems like falls, which can result in fractures or head trauma. By addressing your balance issue early, you save yourself from complications that could be more detrimental to your health."

While temporary episodes of dizziness and loss of balance are common and usually harmless, persistent balance issues warrant medical attention. Understanding the potential causes—whether they stem from the vestibular, vascular, or nervous systems—can help guide appropriate treatment and prevent more serious complications. If you experience ongoing balance problems, don't hesitate to seek professional help to ensure your safety and well-being.