Balance disorders

Balance disorders can make you feel dizzy and affect your ability to engage in daily activities. Many conditions can make you feel off-balance. At Atrium Health Floyd and Harbin Clinic, our doctors identify the cause and provide treatments that can help you feel steadier.

What is a balance disorder?

A balance disorder can make you feel unsteady or dizzy. You may feel like you’re moving when you’re not or like the room is spinning.

Many conditions can affect balance. When your balance is off, you’re more likely to fall and fracture a bone. Balance disorders can make it difficult to walk, drive, work, go to school and enjoy life.

Causes of balance disorders

The vestibular system in your inner ear plays a key role in helping you maintain proper balance. Damage to the vestibular system can make you feel dizzy or off balance. Balance problems can also occur from damage to your visual or sensory systems.

Possible causes of balance disorders include:

• Brain injury
• Ear infection or inner ear abnormalities
• Fast drop in blood pressure (orthostatic hypotension)
• Heart disease
• Medications
• Mental health disorders
• Tumors
• Vision problems

Balance disorder symptoms

Vertigo, a sensation that you’re moving, spinning or floating, is a common sign of a balance disorder. Other symptoms may include:

• Confusion
• Difficulty walking or standing
• Falls and fractures
• Fainting
• Headaches
• Loss of balance
• Nausea and vomiting

Balance disorder types

There are dozens of balance disorders. Some of the more common balance disorders include:

• Benign paroxysmal positional vertigo (BPPV): This inner ear problem causes dizziness when you move your head.
• Labyrinthitis: A virus, such as the flu, can cause inner ear inflammation or infection that affects balance.
• Meniere’s disease: This inner ear disorder causes dizziness, hearing loss and ringing in the ears (tinnitus).
• Perilymph fistula: A head injury, change in air pressure or chronic ear infections cause fluid from the inner ear to leak into the middle ear.
• Vestibular neuritis: Inflammation of the vestibular nerve, a sensory nerve important for balance and eye movements, affects balance.

Balance disorder diagnosis

It can be challenging to pinpoint the cause of a balance disorder. You will likely begin the diagnostic journey with a primary care provider. Because balance disorders often affect the inner ear, they may refer you to an ear, nose and throat (ENT) doctor and/or an audiologist (hearing specialist).

You may get one or more of these tests:

• Hearing test to check for inner and middle ear disorders that affect balance
• Caloric stimulation test to ensure your vestibular system is working and responding to stimulation
• Dix-Hallpike maneuver to see if certain head movements cause vertigo
• Imaging tests, such as CT scan or MRI, to check for brain conditions that affect balance
• Posturography to see how well you can maintain balance on certain surfaces
• Videonystagmography (VNG) to measure your eye movements and assess the muscles that control your eyes

Balance disorder risk factors

Your chances of developing a balance disorder go up as you get older. These factors can also increase your risk:

• Family history of inner ear or balance disorders
• Head injury
• Medical conditions, such as heart disease
• Medications that affect your blood pressure or vision

Complications of balance disorders

A balance disorder can diminish your quality of life and increase your risk of health issues such as:

• Depression, anxiety or other mental health conditions
• Falls
• Fractures from falling
• Vision problems

Balance disorder prevention

You can’t always prevent balance disorders, but these actions may help:

• Do yoga, tai chi and other activities that promote better balance
• Lift weights or use resistance bands to build strong muscles needed for stability
• Manage chronic conditions that can affect balance, such as low blood pressure
• Wear ear protection when exposed to loud noises

Balance disorder treatment

Treatments for balance disorders depend on the underlying cause. In some cases, medications can help. Many people benefit from balance physical therapy (also called vestibular rehabilitation therapy or VRT).

During VRT, a physical therapist with specialized training creates an individualized rehabilitation plan based on your specific needs. You learn exercises in an outpatient setting that help improve your balance and lower your fall risk. We also offer inpatient VRT for certain balance disorders to optimize your recovery.