Falling can cause severe injuries and lead to a loss of independence. We frequently look for ways to prevent falls, but we must first understand balance. Good balance is often taken-for-granted. For most of us, walking across the room, getting out of bed, or stepping up a curb is uncomplicated and trouble-free. However, if we have a damaged or impaired balance system, these everyday activities can be challenging or even dangerous. To understand what balance is, let’s take a look at the human balance system.

The body has a complicated system to maintain our balance when sitting, standing, and walking. The system works through a constant communication process that detects position, provides feedback, and adjusts to keep the body in the place that we intend it to be.  Our brain coordinates sensory information from our feet, major joints (neck, ankles, knees), inner ear, and eyes to maintain our balance. The brain signals to your muscles how to react to movement or a change in position. A properly functioning system allows us to use our sight and feeling to make adjustments and maintain posture and stability. This system includes the eyes (sight), proprioception (skin, touch), vestibular system (inner ear), motor (muscles, joints), and the brain.

What are the signs and symptoms of balance problems? 

• Blurry vision

• Vertigo (sense of spinning or motion when still)

• Feeling like you are falling 

• Falling often

• Lightheaded or feeling faint

• Mobility challenges, difficulty walking, and unsteadiness

• Fear of falling

• Loss of sensation in the feet (neuropathy)

• Nausea 

What can cause an impaired balance system?  There are specific medical conditions that can cause balance problems. Here are some of the most common:

• Vertigo and dizziness:

  • Brain injury due to a concussion or stroke

  • BPPV (Benign Paroxysmal Positional Vertigo) due to calcium crystals that help control balance becoming dislodged in the inner ear, the most common cause of vertigo in adults

  • Migraines are a common cause of vertigo and dizziness

  • Vestibular neuritis is an inflammatory disorder affecting the nerves in the inner ear

  • Inner ear problems often due to fluid build-up from allergies, etc. This is the second most common cause of vertigo.

  • Anxiety causing rapid breathing and too much oxygen

  • Certain medications can cause spinning and dizziness 

• Feeling faint or lightheaded:

  • Postural hypotension is when we stand or sit up too quickly. For some of us, it can cause our blood pressure to drop suddenly. When we sit and rest, the blood pressure returns to normal.

  • Cardiovascular disease such as narrowing or thickening of the arteries causing reduced blood flow throughout our body and brain as well as heart arrhythmias (irregular heartbeat) can also disrupt the blood flow causing lightheadedness and fainting

• Unsteadiness, mobility issues, loss of balance:

  • Inner ear issues. The brain uses our inner ear to determine where our head is and whether our head or body is moving.

  • Nerve damage to your legs (neuropathy) causing the loss of feeling or abnormal sensations like needles sticking into the skin. When we touch or move, millions of nerve cells send signals to our brain about what our body is doing-lying or stepping, for example.

  • Muscle weakness, joint instability, and pain can cause balance challenges

  • Eyesight problems can affect depth perception, night vision, and vision overall. The brain uses images from the eyes to calculate distance, depth, and speed, for example, how far your chair seat is away from us.

  • Neurological conditions such as Parkinson’s Disease

 We must always check with our healthcare provider if we are having problems with our balance. We need to ask if our medical conditions and the medications we take can affect our balance.

Understanding the role of balance is key to preventing injuries from a fall. Maintaining good balance is essential on our journey toward living our best life. 

References: 

Bauch, CD, ed. Mayo Clinic on Better Hearing and Balance. Mayo Clinic Publications; MN; 2014.

VEDA. Scientific Study: The Human Balance System. Vestibular Disorders Association; 2021. Retrieved from: https://vestibular.org/article/what-is-vestibular/the-human-balance-system/the-human-balance-system-how-do-we-maintain-our-balance/.