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In the past several years, I’ve been dismayed to find that my balance isn’t what it used to be.
A few extra pounds and some joint stiffness have me taking more care than I used to when using a stepladder, or even when going out for a walk. My biggest fear is breaking a hip or sustaining a head injury in a fall.
Here is a list of a dozen things that can throw your balance off. If any of them apply to you, this list will help you take precautions now, before unsteadiness becomes a problem.
A dozen things that can impair your balance
1. Diabetes. Poorly controlled diabetes can result in peripheral neuropathy (also known as small fiber neuropathy. Nerve damage causes a lack of sensation in the bottoms of the feet, which makes it hard to balance.
Peripheral neuropathy can be caused by conditions other than diabetes (see #9 below).
2. Inner ear conditions. The vestibular system is a maze-like bony structure in the ear that helps you maintain your balance. Any condition that damages this system, whether an infection, a virus, or a tumor, can cause loss of balance and vertigo.
Benign paroxysmal positional vertigo (BPPV) occurs when calcium crystals in your inner ear are dislodged from their normal position in the inner ear. This is the most common inner ear problem in adults that affects balance. A study published in the journal Neurology found that taking vitamin D and calcium twice daily may reduce your chances of getting BPPV again.
3. Migraines. Research has pinpointed a condition known as migraine-associated vertigo. Like a traditional migraine, it alters blood flow to the brain. Unlike the migraine itself, though, migraine-associated vertigo attacks areas of the brain responsible for balance.
4. Foot pain and foot conditions. Foot problems ranging from bunions to hammertoes to corns can make your footing unsteady and increase the chances of a slip or fall. Low thyroid can also lead to foot pain that could knock you off balance.
5. Low blood pressure. Orthostatic hypotension is a sudden drop in blood pressure that makes you feel dizzy and lightheaded. It occurs most often when you stand up too quickly, but for some people, it just happens. The world falls away, and you become lightheaded and dizzy and lose your balance.
6. Multiple sclerosis. One of the first signs of this autoimmune disease is often loss of balance or numbness on one side of the body. MS attacks the myelin sheath surrounding the nerves. Damage to the myelin surrounding nerves in the cerebellum will affect balance and cause instability and lack of limb control.
7. Medications. The CDC has identified certain sedatives, antidepressants, antihistamines, and blood pressure medications that have been linked to vision issues, dizziness, and inner ear damage, all of which cause impaired balance.
8. Eye diseases. Something as simple as wearing the wrong prescription can make you dizzy. But there are also eye diseases such as glaucoma and cataracts that mess with depth perception and cause dizziness and imbalance.
9. Nerve damage. As mentioned in #1 (above), peripheral neuropathy isn’t only caused by diabetes. Infection, vitamin deficiencies, genetic disorders, alcoholism, and other nerve damage can cause it. While nerve damage is almost always irreversible, catching it early can help treat symptoms more effectively.
10. Parkinson’s disease. This neurologically-based disease results in a decline of muscle control in the arms and legs and a “shuffling” gait that can cause falls. Also, it affects the substantia nigra, the part of the brain that produces dopamine which, among other things, allows us to perform smooth, coordinated muscle movements.
11. Brain tumor. Clearly, there are less dire diagnoses that could be causing difficulty with balance. But a tumor on the cerebellum or substantia nigra of the brain, or on a nerve connecting the ear to the brain, would cause problems with balance.
12. Ramsay Hunt Syndrome. Ramsay Hunt Syndrome (RHS) is caused by the virus that also causes chickenpox and shingles. If you’ve had either of these, the virus could remain and cause a painful rash, weakness and ear pain.
It can also affect the facial, auditory and vestibular nerves of your ears, which is what causes impaired balance.
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Older Adults and Balance Problems — National Institute on Aging