Balance Problems

Basic Facts

What are Balance Problems?

Having good balance means being able to control and maintain your body’s position comfortably—whether you are walking, climbing stairs, standing, or even sitting still.

The terms “balance problems” or “balance disorders” refer to a range of conditions with many different causes but similar sensations—the feeling that you’ve lost your balance or that your sense of up and down is gone.

Most older people feel dizzy briefly at some time or other. In many cases, balance problems disappear on their own within about two weeks. But if you have strong or persistent feelings of dizziness, lightheadedness, faintness, or if you sometimes feel shaky, weak, unstable, or just generally physically insecure, you could have a balance disorder.

To have good balance, your muscles have to work smoothly together in response to several sensory systems:

  • your vision
  • the sensations you get constantly from nerves in your skin, muscles, limbs, and joints (called proprioception)
  • nerve signals from your inner ear 

These sensory systems supply information about your position in space and the pull of gravity. Errors in any of these systems can produce balance problems.

Even when all these systems are working perfectly, the messages still have to be processed, coordinated, and interpreted accurately by your brain and body. Then the right instructions have to travel back out along your nerves to your eyes and muscles. Only then can you “keep your balance.”

Why Balance is Important

Your feelings of dizziness may last only a few seconds or go on for days, weeks, or even longer. Whatever the cause or length of time, you will always find it hard to maintain an upright position while the feeling lasts. You may not be able to carry out simple daily activities such as bathing, dressing, cooking, eating, or getting around your home. 

Your chance of having a problem with your balance may get worse as the years go by. In fact, balance disorders are among the most common reasons that people over the age of 65 see their healthcare providers. It is understandable to feel concerned if you can no longer fully trust your sense of balance.

Loss of balance also raises the risk of falls.  This is a serious and even life-threatening complication. Falls are the leading cause of injuries—including fatal injuries—for people older than 65.

Balance disorders are serious because of the risk of falls.  But occasionally balance problems may warn of another health condition, such as a heart disorder, or a problem in the brain or nervous system. Because of all the possible causes and overlapping symptoms, balance problems can be quite tricky to diagnose. For these reasons, it is important to see a healthcare provider so that the source of your balance problem can be properly and quickly identified. When treatments are needed, they are usually simple and effective.   

The Most Common Types of Balance Problems

The most common symptoms that healthcare providers hear from older patients are:

  • Vertigo.  A sensation that everything around you is spinning or moving, or that you yourself are spinning around.
  • Lightheadedness or “near fainting” (presyncope).  A feeling of weakness, or dizziness.
  • Unsteadiness.  A feeling of imbalance, disorientation, and occasionally a loss of your sense of time, or place

Balance problems may be linked to:

  • inner ear problems (the most common source of vertigo)
  • headaches (including migraines)
  • anxiety or panic
  • ringing in the ears
  • allergies or infections
  • getting up quickly from sitting or lying down
  • a growth on the auditory nerve that works with the ear (such as an acoustic neuroma)
  • problems with nerves in your legs and feet
  • low blood pressure
  • dehydration

The type of experience you have depends on the underlying causes.

How Common are Balance Problems?

Nearly 8 million adults of all ages in the United States report balance disorders each year. About one-third of the older population reports difficulty with balance or walking; the numbers increase significantly after age 75. All in all, almost 40% of older adults are affected.

In adults over age 65, balance problems are linked to falls. One-third of adults in this age group and over half of people over the age of 75 years fall each year. Men and women are affected about equally.


Last Updated November 2016