We’ve all experienced a dizzy spell at some point or the other. But if your sense of balance takes a hit regularly, you have reason to worry. Although we tend to take it pretty much for granted, maintaining balance is a complicated function. And your ear plays a crucial role in this function. Your inner ear, which is known as the labyrinth, contains a complicated system of small tubes known as semicircular canals, nerves, and fluid which tell your brain how your body is positioned and when a movement is causing you to change position.
Being off balance can describe a range of feelings. For instance, you may feel light-headed or experience vertigo, as though your surroundings are spinning. Some people feel like they’re walking on a wobbly surface like a mattress or cotton wool, while others may feel like they’re drunk or even on an unsteady boat. People with a balance disorder may stagger while walking or fall or teeter while trying to stand up.
Other factors also play a role in the balance system. To have a sense of balance, you have to be able to see where you are and know the position of some key body parts relative to the position of other body parts and the space around you. For example, your brain should know how your legs and feet are positioned relative to your shoulders and chest. Position and movement detectors present in your joints, muscles, and tendons pass on this information to your brain. Proper binocular vision is also important for maintaining balance. If any of these sensory systems don’t send proper signals your sense of balance can falter.
Problems With The Inner Ear
Disturbances in your inner ear due to infection, blood circulation problems, aging etc. can cause problems with balance. If inner ear issues are causing you to lose balance, you could also experience hearing problems since both your hearing and balance systems are situated close to each other. So, if you’re also experiencing issues like a buzzing or ringing sound in your ear, or some degree of hearing loss, you should get your inner ear checked. Some balance disorders associated with inner ear problems include:
Labyrinthitis is an inflammation or infection of the labyrinth. In addition to balance problems like vertigo and dizziness, you may also experience symptoms like nausea, hearing loss, and ringing in the ears if you have this condition. Your doctor may prescribe medicines for nausea and dizziness if you have labyrinthitis. Exercises that train the brain to adapt to the imbalance may also be helpful.
Vestibular neuritis is a condition where your hearing nerve or vestibular nerve in the inner ear gets inflamed. This inflammation is typically caused by an infection. Symptoms can range from a violent sensation of spinning to mild dizziness. You may also experience problems with vision, vomiting, nausea, unsteadiness, and impaired concentration.
Ménière’s disease is an uncommon condition that affects your inner ear. It can result in vertigo, a ringing or buzzing sound in your ears, a feeling of pressure in your ear, and loss of hearing. The exact cause of this condition is still unknown. However, some experts suggest that it may be linked to a change in the volume of fluid in the labyrinth.
Benign paroxysmal positional vertigo (BPPV) is characterized by intense and brief spells of vertigo when you change the position of your head. For instance, you may feel like you’re spinning when you tilt your head, look up, or bend down. It is caused when calcium carbonate crystals known as otoconia embedded in your inner ear become loose and move into a chamber of your inner ear known as semicircular canals. The semicircular canals are responsible for balance and perception and this disrupts their functioning. BPPV can develop as you get older or may occur due to a head injury.
Perilymph fistula is a condition which occurs when fluid leaks from the inner ear into the middle ear. It results in unsteadiness that typically increases with activity as well as nausea and dizziness. Perilymph fistula can develop due to a head injury, chronic ear infections, or physical exertion. It may also occur due to a sudden change in air pressure, as is experienced when you go scuba diving. Some people are also born with this condition.
Mal de Debarquement Syndrome
This condition causes a constant feeling of bobbing or rocking. It usually happens after you travel by sea and goes away after a few hours or days on land. However, in some cases, it can persist for months and even years. It is not yet known what causes this syndrome.
Systemic Disorders Like Diabetes And Thyroid Problems
Systemic diseases can also lead to balance problems.
Diabetes causes changes to connective tissues, structures in your inner ear, and the metabolism of inner ear fluid, thus disturbing balance. Nerve damage associated with diabetes can also interfere with your sense of where your body is, causing loss of balance.4 Other signs of diabetes include excessive thirst, frequent urination, tiredness, weight loss, and blurred vision.5
Hypothyroidism is another condition that can cause balance problems. When you have hypothyroidism, your thyroid doesn’t produce sufficient thyroid hormone. In addition to dizziness, this condition can cause weight gain, breathlessness, a sensation of pins and needles, palpitations, a slowing down of thought, speech and movements, loss of appetite, and constipation.6
Poor Blood Circulation
Balance problems caused by poor blood circulation are referred to as vascular vertigo. Reduced blood flow to your inner ear or the lower part of your brain which contains the balance centers can cause a combination of inner ear and brain dysfunction, resulting in balance problems. Vascular vertigo is more common in people who are older and is associated with risk factors like high cholesterol, high blood pressure, diabetes, and smoking. Other symptoms like double vision, loss of peripheral vision, blurred vision, hearing loss, and numb sensation in the limbs or face may also be present. Dizziness by itself is rarely indicative of a vascular cause.
Low Blood Pressure
People who have low blood pressure may experience dizziness when they change positions, such as when they stand up. This is called orthostatic or postural hypotension. When blood pressure dips too low, your brain doesn’t get enough blood supply. This can cause light-headedness, dizziness, and even fainting. Other than dizziness and loss of balance, you may also experience blurred vision, nausea, an irregular or rapid heartbeat, confusion, and general weakness if your blood pressure is low. Lifestyle measures like limiting the consumption of alcohol and caffeine, using support stockings, standing up gradually, not being on your feet for long periods, eating smaller meals regularly etc. can help you deal with this condition.
Some people experience vertigo as a sign of migraine. Common symptoms of a migraine include a severe headache, nausea, and vomiting. You may also experience problems with your vision and speech, have stiffness in your neck, and a heightened sensitivity to noise or light. Avoiding factors which trigger your migraines can be helpful if you’re prone to them. Common triggers include stress, foods like alcohol and cheese, smoking, and certain medications.
Central Neurological Disorders
Although it’s not all that common, some people who experience dizziness and problems with balance suffer from neurological conditions. Strokes, conditions such as multiple sclerosis which affect the nervous system, tumors, and bony deformities near the top of your spine or the back of your head may cause balance issues. The lower part of the brain which also includes the brain stem and the cerebellum is involved in the management of balance. As this area is also responsible for posture, movement, and speech, you may find these aspects are also affected if the cause is a neurological disorder.
Problems With Visual Or Skeletal Systems
As we saw, your visual and skeletal systems also play a part in maintaining balance. And problems with these, such as eye muscle imbalance or arthritis, can result in balance disorders.
Trauma Or Injury To The Head
Trauma to the head, even a minor one, can cause dizziness. This may mean a combination of brain or inner ear problems due to the injury.
Many medicines tend to adversely affect balance. Issues caused by medications can include changes to your vision, lightheadedness, dizziness, or drowsiness. Some drugs can also cause damage to your inner ear. Commonly used medicines that may affect your balance include antihistamines for allergies, anti-anxiety medicines, antidepressants, medicines for blood pressure, pain medication etc.
Older people may be particularly vulnerable to the side effects of medicines since drugs are broken down and absorbed differently when people age. Do speak to your doctor if you suspect that some medication you’re taking could be causing a problem with balance.7
|↑1||Common balance disorders. Hearing Link.|
|↑2||Balance Disorders. National Institutes of Health.|
|↑3||Dizziness and balance problems. The Brain And Spine Foundation.|
|↑4||Walley, Megan, Elizabeth Anderson, Mary Walch Pippen, and Gerry Maitland. “Dizziness and loss of balance in individuals with diabetes: relative contribution of vestibular versus somatosensory dysfunction.” Clinical Diabetes 32, no. 2 (2014): 76-77.|
|↑5||Diabetes. National Health Service.|
|↑6||Hypothyroidism. Thyroid UK.|
|↑7||How medications can affect your balance. Harvard Health Publications.|