Just consider how you would feel if you went on your first cruise and seasickness hit you as soon as you launched. It would take the fun out of things, right? And when you get back on land, you still feel a bit seasick for a while.
Now imagine it’s like that almost all of the time, even when there’s no boat. When you have specific balance issues, it can feel just like that. And in the same way in which that cruise caused sea sickness, balance issues can take the fun (and function) out of pretty much everything.
In some cases, these balance issues are temporary or ebb and flow, in others, symptoms might persist. It will be easier to determine what the cause of your balance issues is, and how to best address it after you get some testing done.
How are balance problems brought about?
Your ears have fluid in them. This is the exact mechanism that makes balance function. You have a tiny bit of fluid in a specialized part of each inner ear, and your brain utilizes information from this fluid to determine your body’s orientation. When everything is normal, this all works great!
You may begin wondering what causes balance problems in the first place when you start to experience symptoms. Usually (but not always), it has something to do with your ear, your brain, or both. Here are some of the most common causes:
- Benign paroxysmal positional vertigo (BPPV): This is a condition where abrupt movements of the head or specific positions of the head can bring about feelings of dizziness and vertigo. An episode of vertigo hits you when you move your head in a specific way.
- Meniere’s disease: Meniere’s disease is a disorder of the inner ear that is distinguished by bouts of vertigo, tinnitus, and ear pressure. Usually, Meniere’s disease starts in one ear before moving to the second, eventually leading to loss of hearing.
- Vestibular neuritis: This is inflammation of the inner ear. Usually, it’s caused by an infection, and it results in temporary dizziness, vertigo, and balance issues. As soon as the infection subsides, symptoms usually disappear.
- Migraines: These severe headaches can result in a large number of symptoms, one of which is balance issues. Typically, as the migraine goes away, so too do the balance issues.
- Head injuries: Dizziness and vertigo can often result from head injuries, including mild concussions to other traumatic brain injuries. The intensity and duration of the balance issues will largely be determined by the severity of the head injury.
- Side-effects from medication: Dizziness and vertigo can be the side effects of some medications. Typically, when you quit using those medications, the symptoms will decrease. Speak with your provider before you discontinue using any prescription medications.
Of course, this isn’t a complete list. Your provider will need to perform special testing in order to ascertain what’s causing your balance issues.
Inner ear testing
Your provider might check your inner ear first when you initially experience your balance issues. As the name suggests, your inner ear isn’t exactly easy to reach. Thankfully, these diagnostics aren’t uncomfortable or intrusive. You could expect some of the following tests:
- Audiometry: Audiometry is essentially a standard hearing test. It checks to see how well you’re able to hear different frequencies of sound. If there’s an issue with your hearing, this will help identify it.
- Tympanometry: Your eardrums are vital to your ears operating correctly. A tympanometry assessment is designed to determine how well your eardrums are moving. A small probe (that looks like a headphone) is put in your ear, and then small puffs of air are sent to your eardrum. The test can determine whether your ear is healthy by measuring the resulting movement of the eardrum.
- Videonystagmography or balance testing (ENG): The idea that this test works indirectly with your ears may be helpful. You use specialized goggles. These goggles help diagnose your balance problems by measuring the movement of your eyes. If something is really off with your balance, this test will help confirm it.
- Electrocochleography (ECOG): This test measures how much electrical energy is created by your cochlea (which is part of your inner ear). Meniere’s disease is diagnosed utilizing this ECOG test.
- Brainstem auditory evoked response audiometry (BAER, BSER): This test tracks your brainwave activity. Basically, your hearing is stimulated and your brain’s response is determined. There may be an issue with your inner ear, or possibly your brain and ears aren’t communicating effectively, or if your brainwave activity is what would be expected, it could be a more broad hearing issue.
- Vestibular evoked myogenic potentials (VEMP) and Auditory brainstem response (ABR): These two tests can sense electrical activity. We will need to determine how well signals are going from your brain to your ears and back. We will put a couple of small electrodes on your head so that we can measure this.
Which assessment is best for you will depend on your overall health and your symptoms. Whether a basic screening or a more objective test is necessary will be identified by your provider.
How are balance problems treated?
Your provider will be better able to offer effective treatment once the source of your balance problems is determined. Treatments are sometimes fairly basic. Some antibiotics may be able to help, for example, if an ear infection is causing your balance problems. More prolonged and intense intervention could be necessary in other cases.
Here are some of the most common treatments for balance problems:
- Medication: In some cases, over-the-counter or prescription medicine can help you manage and minimize symptoms.
- Positioning Exercises: Some types of vertigo can be managed using these exercises. The Epley Maneuver is a prominent and frequently effective example.
- Lifestyle Modification: Symptoms can sometimes be reduced by a lifestyle modification. As an example, you might be able to control your symptoms by quitting smoking or eating a better diet.
- Vestibular rehab: These are exercises that can help improve your balance and, if successful, prevent falls.
- Surgery: In some cases, surgery done by an ENT may be needed to address certain balance problems.
Your balance of power
Balance issues can deeply affect your overall quality of life and your day-to-day safety. If you’re unsteady because you’re dizzy, it’s difficult to walk around your house let alone drive. Once your ENT figures out your balance problems, they will work towards an effective treatment.
But the first step is finding the cause of that relentless sea-sick sensation, so you can feel as if you’re back on dry land again.