Balance is something most of us don’t think about every day. It is one function that we take for granted, but something that is essential. Walking, bending over, driving a car, walking from grass to concrete, getting up in the middle of the night, work related or leisure activities all require balance. Balance problems will increase your risk for fall, interrupt your attention span, cause your sleep patterns to be off, and cause fatigue. Fatigue alone can cause a vast range of other physical, mental and emotional symptoms including:
- chronic tiredness or sleepiness
- sore or aching muscles
- muscle weakness
- slowed reflexes and responses
- impaired decision-making and judgement
- moodiness, such as irritability
The Balance Control Process
Balance is the ability to maintain the body’s center of mass. A properly functioning balance system allows humans to see clearly while moving, identify the space around them, determine direction and speed of movement, and make adjustments to maintain posture and stability in various conditions and activities.
A complex set of sensorimotor control systems that include sensory input from vision (sight), proprioception (touch), and the vestibular system (inner ear and spatial orientation) to maintain balance. Injury, disease, certain drugs, or the aging process can affect one or more of these components. In addition, there may also be psychological factors that impair our sense of balance.
Maintaining balance depends on information received from the eyes, muscles and joints, and vestibular organs ( in each ear includes the utricle, saccule, and three semicircular canals. The utricle and saccule detect gravity (information in a vertical orientation) and linear movement). We rely on our feet and joints to tell us if the surface we are standing on is uneven or moving. We rely on our eyes to tell us if the environment around us is moving or still. And we rely on our inner ears to tell us if we are upright or leaning, or standing still or moving.
Loss of Balance Control
When our ‘auto-pilot’ for balance is disrupted, you may not realize the loss of balance. Our senses of touch, sight, and inner ear motion sensors work together with the brain. When these senses are not communicating with the brain, there is confusion and a sense of falling that is not so. Causes of balance problems include medications, ear infection, a head injury, or anything else that affects the inner ear or brain. Low blood pressure can lead to dizziness when you stand up too quickly. Problems that affect the skeletal or visual systems, such as arthritis or eye muscle imbalance, can also cause balance disorders. Your risk of having balance problems increases as you get older. Many balance disorders start suddenly and with no obvious cause.
The most common causes of loss of balance are:
- Positional vertigo: A brief, intense episode of vertigo triggered by a specific change in the position of the head.
- Labyrinthitis: An infection or inflammation of the inner ear that causes dizziness and loss of balance.
- Ménière’s disease: Episodes of vertigo, hearing loss, tinnitus (a ringing or buzzing in the ear), and a feeling of fullness in the ear.
- Vestibular neuronitis: An inflammation of the vestibular nerve that can be caused by a virus, and primarily causes vertigo.
- Perilymph fistula: A leakage of inner ear fluid into the middle ear.
- Mal de Debarquement syndrome (MdDS): A feeling of continuously rocking, swaying, or bobbing, typically after an ocean cruise or other sea travel, or even after prolonged running on a treadmill.
Is Balance Disorder inevitable in Aging Adults?
Balance disorders are common in older adults and are a major cause of falls in this population. This often leads to injury, disability, loss of independence, and limited quality of life They are associated with reduced level of function. Common causes include arthritis and high blood pressure; however, balance disorders involve multiple contributing factors. Most changes are related to underlying medical conditions and should not be considered an inevitable consequence of aging. Persons who demonstrate unsteadiness require further assessment, usually with a physical therapist, to explain impairments and related functional limitations. Effective options for patients with balance disorders include exercise and physical therapy and will help them not lose their independence.
Identifying and treating balance disorders
- Is there a feeling of unsteadiness?
- Is there is a room spinning sensation?
- Is there a feeling as if sitting on a boat
- Is there a feeling as if one is about to fall
- Is there blurred vision?
- Is there a sensation of being about to pass out?
The first thing a doctor will do to treat balance disorder is to determine if your dizziness is caused by a a medical condition or medication. Your doctor may also prescribe Physical Therapy. The Physical Therapist will perform motion, strength, coordination, visual tracing, and balance tests to assess your overall physical ability. They will also collaborate with your physical or other healthcare professionals to rule out underlying conditions and help create a plan of care to help get your balance back.