March 18, 2019

Feeling Unsteady? What You Should Know About Balance Problems

Is it clumsiness or something more serious?

Man balancing on edge

You bump into tables all the time. You’ve lost count of the number of times you’ve stubbed your little toe on the doorframe. When you practice yoga, your tree pose looks more like a … fallen tree.


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Are you a little clumsy? Or could your balance problem be something bigger?

Usually, true balance disorders go beyond run-of-the-mill klutziness, says audiologist Julie Honaker, PhD, CCCA, Director of the Vestibular and Balance Disorders Program.

But “balance disorders” include a broad range of problems, from minor lightheadedness to feeling like you’re standing on a boat (on one foot, during a hurricane).

Dr. Honaker shares more about the common causes of balance problems — and how to keep marching steady.

Symptoms of vestibular disorders

The inner ear is the HQ for the body’s balance, or vestibular, system. When something goes awry with that system, a whole range of symptoms can result, including:

  • Lightheadedness.
  • Coordination problems.
  • Struggling to walk in a dark room.
  • Veering left or right when walking.
  • Dizziness or vertigo (a spinning sensation).
  • Stumbling or feeling unstable on your feet.
  • Sensitivity or difficulty with vision and hearing.

Causes of dizziness

Any number of other things can knock your balance off-kilter, Dr. Honaker says. Something relatively minor, like dehydration or fatigue, can cause a bout of unsteadiness. But what if you’re hydrated, rested — and still stumbling? These are some of the usual suspects.

Medication side effects

Medication is one of the most common culprits of balance problems.


“So often, dizziness is listed as a side effect of medications,” Dr. Honaker points out. If you’re taking multiple prescription meds, they’re even more likely to interact in ways that leave you wobbly.

Viral infections

A virus can infect the ear and derail your sense of balance. Sometimes, colds can cause pressure changes in the middle ear, with the same dizzying effects. These infections usually resolve on their own.

Ear crystals

Don’t get too excited — this is less blingy than it sounds. Turns out, we have tiny crystals of calcium carbonate in the inner ear, which play a role in gravity sensing. (Who knew?) Sometimes, the crystals meander into parts of the inner ear where they don’t belong, Dr. Honaker says.

When that happens, you can feel like the room is whirling around you — especially when you move your head suddenly, like rolling over in bed or tipping your head back for a shampoo at the salon. The official name of this disorder is a mouthful: benign paroxysmal positional vertigo. It’s the most common cause of vertigo (and, phew, it’s treatable).

Meniere’s disease

Meniere’s disease causes large amounts of fluid to collect in the inner ear. In addition to dizziness, it can cause hearing problems and ringing in the ears.

The bad news: Meniere’s attacks are unpredictable and may be severe. The good news: You can often manage the disease with diet changes and medication.


You are older and wiser — but perhaps slightly less steady. The inner ear balance system can decline as you age, Dr. Honaker says. Meanwhile, the strength of your eyesight, hearing and even sense of touch can deteriorate — all of which can contribute to poor balance.


But pull on your yoga pants and grab your mat, because balance-boosting exercises like tai chi and yoga can help keep you steady. “It’s important to engage our balance system through regular exercise,” Dr. Honaker says. “If you don’t use it, you lose it.”

When to see a doctor for balance problems

If something seems off with your balance, it’s wise to see a doctor to investigate possible suspects, Dr. Honaker says.

Inner ear problems are often to blame, so definitely mention symptoms such as changes in hearing, ringing or a feeling of fullness in the ears. But sometimes, the problem is related to other issues, such as neurological problems or even heart problems.

Since so many different things can mess with your balance, it makes sense to talk to your primary care doctor first. He or she can help narrow down the suspect list before you visit any specialists.

Many vestibular problems are treatable, Dr. Honaker says, so don’t be afraid to get to the bottom of it.

How to prevent falls

To prevent falls, Dr. Honaker has this advice:

  1. Get strong. A strong body, particularly your core, will improve your balance and help you avoid falls. Consult a doctor first, but you could try tai chi, yoga or even standard strength training.
  2. Use handrails. Always use handrails when walking up and down stairs. Falls can happen at any age. Making it a rule to use the handrails could save you from a serious injury.
  3. Remove hazardous items from the floor. Remove hazardous items from the floor that may trip people, such as stools and scatter rugs.
  4. Wear low-heeled, flexible shoes with a good tread. For women, it’s tempting to wear high heels, but flats are a safer option if you are worried about losing your balance. For men and women, be sure to wear shoes that have a good tread so you don’t slip on slippery floors.
  5. Safety-proof your home. Place hand grips in the bath and shower and always use handrails when walking up and down stairs. Use adequate lighting or night lights to safely walk around your home at night.

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