Balance Problems

Symptoms

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

  • Unsteadiness. A feeling of imbalance, disorientation, and occasionally a loss of your sense of time, or place
  • Vertigo or Dizziness. 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 that you might lose consciousness. Note: If this feeling is new or severe, it requires urgent medical attention.

Balance problems may be linked to:

  • problems with nerves in your legs and feet
  • low vision
  • weak muscles
  • medication side effects
  • pain
  • getting up quickly from sitting or lying down
  • low blood pressure
  • dehydration
  • inner ear problems (the most common source of vertigo)
  • anxiety or panic
  • allergies or infections
  • common diseases including dementia, Parkinson’s, arthritis, stroke, and diabetes
  • a growth on the auditory nerve that works with the ear (such as an acoustic neuroma; this is relatively rare)
  • a combination of several of these

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

You may experience different symptoms from your balance problems. Evaluating these symptoms helps your healthcare provider diagnose each type of balance problem.

Neurological problems

  • Neuropathy
  • Weakness after having a stroke
  • Transient ischemic attacks (TIAs) or “mini-strokes”
  • Parkinson’s disease

Musculoskeletal problems

  • Physical deconditioning (being “out of shape”)
  • Degenerative joint disease
  • Rheumatological conditions

Inner ear problems

Benign Positional Paroxysmal Vertigo (BPPV) can be diagnosed if the following signs are present:

  • Vertigo is the main symptom, and lasts for a few seconds to minutes
  •  Vertigo is brought on by changing head position
  • A positive Dix-Hallpike test 

Labyrinthitis is suspected if you have:

  • Vertigo that starts suddenly and is not related to head or body position
  • Vertigo that is associated with nausea and vomiting
  • Vertigo that continues for days
  • Side-to-side eye movements which stop when eyes are fixed on an object

Meniere’s disease is identified by the presence of:

  • Two spontaneous episodes of vertigo, each lasting at least 20 minutes and continuing for hours in many cases
  • Confirmed hearing loss
  • Tinnitus (ringing in the ears) or a feeling of fullness inside one ear
  • No other known causes for these problems

Sudden low blood pressure (orthostatic hypotension) 

  • Dizziness or lightheadedness lasting from a few seconds to minutes as the main symptom
  • The dizziness and light-headedness appear within one to three minutes after sitting up or standing up
  • Blurred vision, reduced hearing, head or neck pain, sweating
  • A drop in blood pressure when sitting up or standing up
See a healthcare professional or call 911 right away if you have sudden balance problems or dizziness or vertigo along with any of the following:
 
  • a head injury
  • a severe or unusual headache
  • fever higher than 101 degrees Fahrenheit
  • a stiff neck
  • blurred vision
  • sudden hearing loss
  • speech difficulties
  • leg or arm weakness or numbness
  • a fall
  • trouble walking
  • chest pain
  • unusually fast or slow heart rate
  • loss of consciousness

Last Updated December 2020