Picture taking a cruise and immediately getting seasick. That could really spoil a nice day. And there’s always that adjustment stage when you get back on land where you can still feel the movement of the ship beneath your feet.
Now imagine it’s like that nearly all of the time, boat or no boat. When you have certain balance issues, it can feel just like that. And just like that cruise triggered sea sickness, balance issues can take the fun (and function) out of just about anything.
These balance symptoms might come and go or they might be more persistent. Testing to identify the cause of the balance problems you’re experiencing can help you discover more effective, longer-lasting solutions.
What can cause balance issues?
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 uses information from this fluid to figure out your body’s orientation. When things are normal, this all works great!
So when you start to encounter symptoms of balance problems, you might start thinking about what could trigger balance issues in the first place. Typically (but not always), it’s related to your ear, your brain, or both. Some of the most prevalent causes include:
- Benign paroxysmal positional vertigo (BPPV): This is a condition in which abrupt movements of the head or specific positions of the head can cause feelings of dizziness and vertigo. An episode of vertigo strikes you when you move your head in a particular way.
- Meniere’s disease: Bouts of tinnitus, vertigo, and ear pressure distinguish the symptoms of this disorder. Menier’s disease will eventually result in hearing loss after starting in one ear and then moving to the other.
- Vestibular neuritis: When you have inflammation of the inner ear, it’s called vestibular neuritis. An infection is normally the cause and the outcome is short-term vertigo, dizziness, and balance issues. Symptoms will normally disappear when the infection subsides.
- Migraines: These severe headaches can initiate a large number of symptoms, one of which is balance issues. These balance problems will usually go away when the migraine goes away.
- Head injuries: From slight concussions to more profound head injuries and brain trauma, dizziness and vertigo can frequently be an outcome. The intensity and duration of the balance problems 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. Those symptoms will typically come under control when you quit taking the medication. Speak with your provider before you discontinue taking any prescription medications.
This list is not complete, of course. In order to figure out what the cause of your balance issues is, your provider will need to perform specially developed testing.
Testing for inner ear problems
Your provider may check your inner ear first when you initially experience your balance issues. Your inner ear can be a bit hard to reach, as the name implies. These tests aren’t invasive or painful, luckily. Here are a few of the tests you might expect:
- Audiometry: Audiometry is basically a standard hearing assessment. It tests to see how well you can hear different frequencies of sound. If there’s a problem with your hearing, this will help determine the cause.
- Tympanometry: Your eardrums are critical to your ears operating correctly. A tympanometry test is developed to see how effectively your eardrums are moving. A slight amount of air is directed into the eardrum by a tiny probe that looks like a headphone. The test measures the resulting movement of your eardrums, and can then help identify whether your ear is healthy.
- Videonystagmography or balance testing (ENG): It may help to think of this test as working indirectly with your ears. You use specialized goggles. These goggles help diagnose your balance issues by measuring the movement of your eyes. If something is really off with your balance, this test will help verify it.
- Electrocochleography (ECOG): This test calculates how much electrical energy is produced by your cochlea (which is part of your inner ear). ECOG tests are crucial in diagnosing Meniere’s disease.
- Brainstem auditory evoked response audiometry (BAER, BSER): Your brainwave activity is monitored by this test. Essentially, it watches for activity in response to hearing stimulus. If the activity isn’t what’s anticipated, there could be a problem with the inner ear, how your ears and brain are communicating, or with your hearing more broadly.
- Vestibular evoked myogenic potentials (VEMP) and Auditory brainstem response (ABR): Electric activity is measured using these two tests. In general, you’ll have a couple of little electrodes placed against your skin (typically on your head), and they’ll help establish how well signals are traveling from your brain to your ears and back again.
Which test is best for you will depend on your general health and your symptoms. Whether a basic screening or a more objective test is needed will be established by your provider.
How do you manage balance issues?
Once you’ve identified the cause of your balance issues, your provider will be better able to provide practical treatment. In some cases, therapies will be rather basic. Some antibiotics may be able to help, for instance, if an ear infection is causing your balance problems. In other cases, more intense and continued interventions could be required.
Some of the most prevalent treatments for balance issues include the following:
- Medication: In certain situations, over-the-counter or prescription medicine can help you control and alleviate symptoms.
- Positioning Exercises: These exercises can help with certain types of vertigo. The Epley Maneuver is a popular and often effective example.
- Lifestyle Modification: Symptoms can sometimes be reduced by a lifestyle change. For example, eating more fruits and vegetables or quitting smoking could help manage your symptoms.
- Vestibular rehab: Your balance can be improved by these exercises and they might help prevent falls.
- Surgery: There are some scenarios where you will need to have an ENT perform surgery.
Your balance of power
Your day-to-day safety, not to mention your overall quality of life can be seriously affected by balance problems. It’s difficult to drive, or even walk around your home when you feel dizzy and unstable. We will be able to diagnose your balance issues and start working towards an effective treatment.
You need to feel as if you’re back on dry land, so finding the cause of that constant seasick feeling is the first step.