Many of us have had someone in our lives who has experienced balance problems as they aged. In fact, it’s easy to think of balance problems as a regular and expected part of aging, something that we all just have to learn to live with. Eventually, we all may feel a bit unsteady when walking and find ourselves occasionally reaching for a wall or piece of furniture for some extra stability.
Balance problems are a major reason for a loss of confidence and independence in seniors. Balance problems also make falling much more likely, and falls are the leading cause of injury for adults aged 65 and older1.
The truth is that balance problems are not always an inevitable part of aging, and neither are the loss of independence and risk of injury that come with them. Many times, balance problems indicate an underlying problem that can be addressed and improved.
Balance Is More Complex Than Most People Realize
When we see balance problems in an older person, it’s easy to assume that it’s due to weakening muscles and joints. While muscles and joints are certainly an important part of balance, they don’t tell the entire story. Balance depends on several systems working together:
- The inner ear (vestibular system)
- The nervous system and brain
- Vision
- Muscles and joints
Balance depends on your brain constantly combining information from your eyes, inner ear, and body to maintain stability. It is about more than the strength and stability of your muscles and joints. If any one of the above systems is lacking, balance can suffer.
Your Inner Ear Can be a Source of Balance Problems
It can be surprising to learn that some balance problems originate in the inner ear rather than the legs, hips, or feet. If your balance problems stem from your inner ear, you may experience one or more of the following symptoms:
- Dizziness
- Vertigo (room-spinning sensation)
- Feeling pulled to one side
- Motion sensitivity
- Unsteadiness while walking
There are many different inner ear conditions that can lead to balance problems, including Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuritis, and age-related vestibular decline.
Fortunately, in cases where inner ear, or vestibular, problems are impacting a person’s balance, there are effective treatment options. A type of therapy known as vestibular rehabilitation has proven to be very effective in treating many of these conditions and improving symptoms2.
Your Nerves May Be Part of the Problem
Your brain relies on receiving good information from your feet, ankles and other body parts to maintain stability. If that feedback loop is compromised in any way, it can lead to balance problems. Problems of the nervous system outside your brain fall under the general term of peripheral neuropathy, and can be associated with the following symptoms:
- Numbness
- Tingling
- Burning sensations
- Difficulty feeling the ground beneath your feet
These nervous conditions can be caused by a chronic disease like diabetes, nerve injuries, certain medications, or age-related sensory changes. While peripheral neuropathy is often treated with medication, the efficacy of medication is often limited and there are significant risks. For this reason, other non-pharmaceutical treatments like exercise and physiotherapy are often recommended3.
Muscle Weakness and Deconditioning Can Play a Role
Sometimes balance problems aren’t caused by dizziness or nerve problems at all. Sometimes it’s as simple as a loss of strength. Even though your brain is working hard to interpret data and maintain your stability, your body still needs sufficient strength to make the constant small corrections that keep you upright and prevent falls.
Muscles can weaken over time from disuse or aging. This can happen following a period of inactivity due to an injury, or just basic weakening that can occur over time if you are not moving and exercising regularly. Balance problems can stem from muscle weakness in your legs as well as your core muscles. Symptoms of balance problems caused by muscle weakness can include:
- Difficulty rising from a chair
- Trouble climbing stairs
- Feeling unsteady during longer walks
- Needing handrails more often
If your balance problems are caused by muscle weakness, the best treatment is pretty straightforward: build strength. Regular exercise is a great idea for many reasons, not the least of which is maintaining balance and stability throughout your life.
Your Joints Can Also Throw Off Your Balance
In addition to the importance of having the muscle strength required to maintain stability, if your joints are not holding up their end of the bargain balance problems are sure to follow. Often, joints problems are caused by compensations for discomfort in some other part of the body. People naturally compensate for discomfort, shifting weight unevenly or avoiding natural movements. Joint problems can also come from chronic inflammatory conditions like arthritis.
If you experience chronic pain in your knees, hips, or ankles, you are likely to have some balance problems. You are also likely to unconsciously compensate for the pain by placing additional stress on other joints, leading to a continuous cycle of pain and discomfort.
Preferred treatments for joints problems can vary, depending on the type and severity of your condition.
Ignoring Balance Problems Can Be Risky
Aside the risk of falls, balance problems can have a large impact on a person’s quality of life. A lack of confidence and fear of falling can significantly reduce your independence. It can make you less active, which can accelerate weakness and make your balance problems worse. The sooner you address your balance problems, the more easily and effectively you will be able to address them.
Whatever the cause of your balance problems, reach out to a competent physical therapist as soon as possible. A physical therapist is uniquely qualified to provide a professional assessment that considers all of the possible underlying causes of your balance issues. They will be able to assess your:
- Strength
- Mobility
- Walking mechanics
- Vestibular function
- Functional movement patterns
After your evaluation, your PT can develop a personalized treatment program to help you correct and overcome your balance problems. That treatment program may include:
- Balance training
- Strengthening exercises
- Vestibular rehabilitation
- Gait training
- Fall prevention strategies
- Home exercise programs
Don’t let balance problems deprive you of your confidence and independence. They are not always and necessary part of aging and they are not something you have to learn to live with. Whether your problems stem from your inner ear, your nerves, your vision, or your muscles and joints, there are treatment options that are both safe and effective.
Sources
- Centers for Disease Control and Prevention. “Older Adult Falls Data.” Older Adult Fall Prevention, 28 Oct. 2024, www.cdc.gov/falls/data-research/index.html.
- Sulway, Shaleen, and Susan L. Whitney. “Advances in Vestibular Rehabilitation.” PubMed, S. Karger AG, 2019, pubmed.ncbi.nlm.nih.gov/30947180/.
- Jesson, Tom, et al. “Physiotherapy for People with Painful Peripheral Neuropathies: A Narrative Review of Its Efficacy and Safety.” PAIN Reports, vol. 5, no. 5, Sept. 2020, pp. 1-e834, https://doi.org/10.1097/pr9.0000000000000834.
