Balance Problems

Balance problems, also known as balance disorders, can make you feel unsteady or dizzy. Balance helps you stay steady when you walk, stand or move. To do that, your body relies on signals from your eyes, inner ears, muscles and brain. These systems work together to tell you where you are in space and how to stay upright. When something disrupts that process, you might feel wobbly or off-balance.

Balance issues often point to another health problem. Treating the cause — and sometimes, doing physical therapy — can help you feel steady again.

How your body maintains balance

Balance depends on how your senses and nervous system work together.

Here’s how it works:

• Inner ears (vestibular system): Sense motion and gravity through canals and tiny organs in your ears
• Eyes (vision): Track your surroundings to help your brain know where your body is in space
• Skin, joints and muscles: Send signals about pressure and movement (for example, if you lean back, pressure in your heels tells your brain you’re off balance)

Your brain uses all this input to keep you balanced. If something goes wrong, it may not process the signals right, and you might feel dizzy or off.

Symptoms of balance problems

Balance problems feel different depending on the cause. You may notice:

• Blurred vision: Trouble seeing clearly, especially when moving
• Dizziness: A woozy or disoriented feeling
• Lightheadedness: Feeling faint or like you might pass out
• Unsteadiness: Feeling wobbly when you stand or walk
• Vertigo: A spinning feeling, even when you’re still

These symptoms can come on fast or slowly. Some people feel them only in certain situations, like when standing up quickly or being in a crowded place.

Balance problem causes

Many things can affect your balance. It’s more common with age, but it can happen to anyone. Causes usually fall into two groups: inner ear problems and other health conditions.

Inner ear disorders

Your inner ear plays a major role in helping you stay balanced. Conditions that affect this area include:

• Acoustic neuroma: A noncancerous tumor on the nerve that helps with hearing and balance
• BPPV (benign paroxysmal positional vertigo): Short bursts of dizziness when you move your head, like when lying down or rolling over in bed
• Labyrinthitis: Swelling in the inner ear, which affects balance and hearing
• Ménière’s disease: Sudden dizziness, often with hearing loss, ear pressure and ringing in the ear
• PPPD (persistent postural perceptual dizziness): Ongoing dizziness triggered by motion, crowds or screens
• Vestibular neuritis: Swelling in a nerve that helps your brain process balance signals

Other health conditions

Balance issues can also result from a wide range of health problems, including:

• Head injuries: Concussions or brain injuries can affect balance short- or long-term.
• Heart disease: Poor blood flow may cause dizziness or fainting.
• Migraines: These can cause dizziness during episodes.
• Motion sickness: Travel or screen time can trigger dizziness and nausea.
• Neurological disorders: Diseases like Parkinson’s or Alzheimer’s can affect balance control.
• Orthostatic hypotension: This is a sudden blood pressure drop when you stand up.
• Peripheral neuropathy: Nerve damage in hands or feet affects your body’s signals.

How doctors diagnose this condition

Your provider will start with a physical exam and ask about your symptoms. They may do vestibular tests to see how your eyes, ears and brain work together to keep you balanced.

Here are some of the most common tests:

• DVA (dynamic visual acuity test): You read while your head is still and again while moving to see how motion affects your vision.
• mCTSIB (Modified Clinical Test of Sensory Interaction on Balance): You stand on different surfaces with your eyes open and closed to test balance.
• Rotary chair test: You sit in a turning chair while goggles measure your eye and ear response.
• vHIT (Video Head Impulse Test): You focus on a target while your provider quickly moves your head. Goggles track your eyes.
• VEMP (vestibular-evoked myogenic potentials): You hear sounds while sensors track how your neck or eye muscles respond.
• VNG (videonystagmography): You’ll wear goggles that track your eyes while you follow a moving object.

How are balance issues treated?

Treatment depends on the cause of your balance problems. Your provider will treat that condition, whether it’s in your ear, brain or somewhere else.

They may also suggest vestibular rehabilitation therapy (VRT) — a special kind of physical therapy that uses exercises to improve balance and reduce dizziness.

When should I see my healthcare provider?

If you often feel unsteady or off balance, talk to your healthcare provider. It’s especially important to let them know if your symptoms aren’t improving with treatment — or if they’re getting worse. You could be dealing with an underlying issue that needs a different approach. In some cases, you may need adjustments or updates to your care plan to help you feel more stable and safe.

What can I expect if I have balance problems?

Your provider will help you through diagnosis and treatment. If a health issue is causing your balance problems, they’ll focus on treating that first.

You may also need therapy to help your brain and body adjust. Recovery takes time, but with care, most people feel better and more confident.