A balance disorder is a general phrase used to label many different conditions that end up looking like the same thing. At least three systems in the body are involved in maintaining balance. If you, or someone you care about, no matter their chronological age, starts to:
- have trouble controlling how quickly or slowly they walk,
- bump into things,
- stagger, especially when going around corners,
- generally, have trouble standing,
- trip when going up or down stairs,
- have trouble changing position (like standing up, sitting down, rolling from side to side),
- feel dizzy, nauseous, or throw up after quick or sudden head movement,
Some balance issues could be at the root of it all.
Balance problems can be a warning of a severe health problem. They can be blood pressure issues, brain problems, circulatory issues, and aftereffects from head injuries. In 2008, according to the National Institute of Health, an estimated 33.4 million American adults reported a balance or dizziness problem during the previous twelve months. A number of things can cause these signs to appear.
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Types of Balance Disorders
Many balance disorders are temporary. In children, they can be an outward sign of learning to walk or manage a rapidly-growing body. Most children’s balance issues, even those with a medical origin, often resolve themselves without medical intervention.
The more permanent types of balance problems are not expected. Here’s a list of types and causes of balance issues that are found in the adult population:
- Temporary condition due to alcohol consumption, drug use, medication interaction, Disease, or motion (usually of a car or boat).
- The aftermath of a head injury is often a concussion or blunt-force trauma.
- Aging. Simply growing older can create balance challenges for some people.
- A side effect of a stroke, migraine headache, or seizure.
- Sudden change in blood pressure, often from changing position (like standing up or bending over) too quickly.
- Middle or inner ear infections can cause vestibular neuronitis (inflammation of the vestibular nerve) and labyrinthitis (inflammation of the labyrinth, an inner ear part) and affect the vestibular system, the body’s primary balance system.
- Meniere’s Disease usually affects the balance mechanism in one ear by causing problems with the inner ear fluid. Symptoms include vertigo (dizziness), tinnitus (ringing in the ears), partial hearing loss that comes and goes, and a sensation of ear congestion and ear pressure. It can occur in anyone but usually appears in persons 40 – 60 years old. The cause of this Disease is unknown.
- Inner ear issues cause benign Paroxysmal Positional Vertigo (BPPV).
- Eye problems – most notably nystagmus, involuntary eye movements that can wreak havoc with an individual’s sense of balance.
- Skeletal and muscle problems.
- Unknown origins – balance problems are starting suddenly and have no apparent cause.
- Vertigo symptoms – a sense of immediate surroundings spinning. This unpleasant, unsteady feeling is often accompanied by nausea and vomiting.
- Dizziness – feeling giddy, having the sensation that everything is spinning around you.
- Disequilibrium – feeling off-balance physically and falling in the same general direction. Nausea and vomiting usually do not occur with this symptom.
- Lightheadedness – a sense of faintness, but not necessarily fainting.
- Blurred vision or involuntary eye movements (nystagmus).
- Feelings of confusion or disorientation.
- Fatigue – tiredness from the effort of accommodating and adapting to the imbalance. This tiredness is often proportional to the amount of effort expected to be expended in an activity.
- Fear, anxiety, and depression – are psychological states that can arise from not knowing one has a balance disorder and, as a result, not being able to function in usual ways.
Issues with physical balance can occur with no warning. They can happen once or several times, be short episodes or last for months or years.
Balance is a function of several different body subsystems cooperating. For convenience, it is called the Vestibular System, but keeping our balance is a complex interaction of the inner ear, vision, and musculoskeletal subsystems. Therefore, the correct diagnosis of a balance disorder is equally as complex.
Whenever a doctor is presented with a patient who complains of a balance disorder, the first order of business is to rule out any external physical cause. This includes (but is not limited to):
- Falls, accidents, or injuries, especially anything affecting the head
- Medications and possible interactions. This includes over-the-counter medications, herbal preparations, pain relievers, and sleep aids.
- Ototoxic medications are drugs intended for other uses (like antibiotics or chemotherapy) that damage the inner ear.
- Chronic infections
- Substance abuse, such as alcohol or drugs
- Recent new activities
- Environmental factors, such as a new living or work space, new carpeting or drapes, or any change in any surroundings
- Allergies, such as pets, plants, clothing, food, or fragrances
A doctor may consult with other professionals before making a diagnosis. This can take the form of a formal presentation at a specialist’s meeting, a more informal conversation with another doctor, or going to research sources only available to medical professionals. Based on the results of these fact-finding activities, the next step may be:
- Referral to an audiologist, an otolaryngologist (ear-nose-throat doctor, also called an ENT), and a neurotologist (a specialist in ear disorders)
- MRI scan – magnetic resonance imaging, a technology that uses magnets to see what is going on inside the body without performing any invasive procedures
- CT scan – computerized tomography, which is an x-ray procedure that takes x-ray photos in ‘slices’ to build up a three-dimensional picture of that part of the body
- Electronystagmography – testing eye movements since a major component of balance is the interaction of eyes and ears.
- Posturography – testing how the body responds to movement or presented patterns
- Other diagnostic tests
Balance disorders are much more than a feeling of dizziness or vertigo. They also have far-reaching effects on those stricken with the condition. Balance disorders do not have simple solutions. They are complex conditions that need to be addressed on more than one level.
Physical Aspects of Treatment
Most of the time, Who must retrain the body to deal with the changes in the vestibular system. Vision, hearing, and proprioception (knowing where your body is and how it’s oriented in space without looking at it) need to learn to work together again. A physical therapist has training and experience working with people with balance disorders. Physical therapy can help:
- Lessen the impact of balance issues on daily activities
- Teach how to adapt to changes in the world of an individual with balance challenges
Different balance disorders have different approaches to dealing with what looks like similar conditions. For example, doctors perform the Epley maneuver with individuals who have been diagnosed with BPPV to relieve symptoms of vertigo and help the vestibular system return to proper functioning. On the other hand, those dealing with Meniere’s Disease usually work with their treatment team to relieve symptoms only because this condition has no cure.
All balance challenges benefit from:
- High-quality nutrition
- Low-sodium intake
- Enough fluid intake to prevent dehydration
- More muscular abdominal and spinal erector muscle groups
- Enough rest, which translates to not getting too tired
- Stability aids, such as stable footwear, canes, and walkers, help prevent falls
Psychological Aspects of Treatment
Regardless of the type of balance issue an individual has, a counselor or psychotherapist can help a person recognize and come to terms with the life changes a balance disorder can cause.
Even though the treatment team has implemented it and everyone is working on the treatment plan, it may take more time than the patient likes before seeing any physical improvements. In addition, the fear, anxiety, and depression that may arise after such a radical change in functioning are real issues, not products of the imagination. Therefore, paying attention to and addressing psychological and physical problems is just as important.
As soon as possible after the diagnosis is made, a mental health professional needs to become part of the treatment team. Waiting for signs of psychological distress to appear before acting to deal with that distress robs patients and those in their support systems of tools they could have used to lessen or prevent its adverse effects.
It is more than possible Who will need only one or two visits with a mental health professional. Preventing the mental anguish that may arise from such a sudden change in the ability to function is much more effective than trying to cure it.
Support groups are another tool available for the person dealing with balance challenges. They can be used by some people instead of, or before starting to work with, or at the same time they are working with, a mental health professional.
Meeting others dealing with similar issues helps emphasize to them that they are not alone. In addition, support groups provide the chance to speak with people who live with balance issues and gain non-medical perspectives, insights, and observations.
Group members who have lived and dealt with balance issues for a longer time than the newcomer can offer practical tools for dealing with some of the unique challenges that come up, bring a sense of humor to the situation, and suggest resources the newcomer may not know to exist. Support groups also provide a venue to frankly talk about personal experiences and issues without having to feel it necessary to ‘put on a happy face.’
An important thing to remember is that balance disorders in and of themselves are not fatal. Some, especially those that appear in childhood, resolve themselves in time and go away independently. Those that occur during adulthood, though, require adaptation to the condition. Sometimes, changes in nutrition, types of exercise, and awareness of surroundings can have a dramatically positive effect.
Much information about balance disorders is available from doctors and pharmacists, on the Internet, in libraries, and through professional associations. This article touches on the basics of a complex group of conditions that can appear out of nowhere and stay for the rest of a person’s life. Doing more research is a crucial piece of the peace of mind puzzle.