Picture taking a cruise and instantly getting seasick. It would take the fun out of everything, right? And there’s always that adjustment period 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 almost all of the time, boat or no boat. When you have certain balance issues, it can feel just like that. And balance problems, much like that seasickness, can take the fun out of everything.
In some situations, these balance problems are temporary or ebb and flow, in others, symptoms could persist. Testing to figure out the cause of the balance problems you’re experiencing can help you discover more reliable, longer-lasting treatments.
How are balance problems brought about?
Your ears contain fluid in them. That’s it, that’s how balance functions! You have a little bit of fluid in a special part of each inner ear, and your brain utilizes information from this fluid to figure out your body’s orientation. When everything is normal, this all works great!
You may begin to wonder what causes balance problems in the first place when you start to experience symptoms. In most instances, your ear, brain, or both are the culprit. Here are a few of the most common causes:
- Benign paroxysmal positional vertigo (BPPV): This is a condition in which abrupt movements of the head or specific positions of the head can trigger feelings of vertigo and dizziness. An episode of vertigo strikes you when you move your head in a certain way.
- Meniere’s disease: Bouts of tinnitus, vertigo, and ear pressure characterize the symptoms of this condition. Menier’s disease will eventually result in hearing loss after beginning in one ear and then moving to the other.
- Vestibular neuritis: When you have inflammation of the inner ear, it’s known as vestibular neuritis. Usually, it’s caused by an infection, and it leads to short-term dizziness, vertigo, and balance issues. Symptoms will usually disappear when the infection subsides.
- Migraines: A large number of symptoms can be brought on by these severe headaches, including problems with balance. These balance issues will usually go away when the migraine clears.
- Head injuries: From slight concussions to more severe 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 certain medications. Usually, when you stop using those medications, the symptoms will decrease. Talk to your provider before you discontinue taking any prescription medications.
This list isn’t exhaustive, of course. In order to identify what the cause of your balance issues is, your provider will have to perform specially designed testing.
Testing for inner ear issues
Your provider may check your inner ear first when you initially experience your balance problems. Your inner ear can be a bit difficult to reach, as the name suggests. These assessments aren’t invasive or painful, fortunately. You might expect some of the following tests:
- Audiometry: Audiometry is essentially a standard hearing assessment. It tests to see how well you can hear different wavelengths of sound. If there’s an issue with your hearing, this will help identify it.
- Tympanometry: Your ears only work correctly when your eardrums are working properly. A tympanometry test is developed to determine how well your eardrums are moving. A slight amount of air is directed into the eardrum by a little probe that looks like a headphone. The test measures the resulting movement of your eardrums, and can then help figure out whether your ear is healthy.
- Videonystagmography or balance testing (ENG): It might help to think of this test as working indirectly with your ears. You use specialized goggles. These goggles measure the movement of your eyes, helping to identify where your balance problems are coming from. If something is very off with your balance, this test will help confirm it.
- Electrocochleography (ECOG): The amount of electrical energy produced by your cochlea (part of your inner ear) is measured by this test. ECOG assessments are essential in diagnosing Meniere’s disease.
- Brainstem auditory evoked response audiometry (BAER, BSER): Your brainwave activity is monitored by this test. Basically, your hearing is stimulated and your brain’s response is measured. There might be an issue with your inner ear, or perhaps your brain and ears aren’t communicating successfully, or if your brainwave activity is what would be anticipated, it could be a more broad hearing issue.
- Vestibular evoked myogenic potentials (VEMP) and Auditory brainstem response (ABR): These two assessments can detect electrical activity. We will need to figure out how well signals are traveling from your brain to your ears and back. We will apply a couple of small electrodes on your head in order to measure this.
Your general health and your symptoms will identify which one of these tests is correct for your circumstance. In general, your provider will be able to figure out when you need a basic screening or when a more objective test may be required.
How are balance issues managed?
Your provider will be better able to offer effective treatment once the source of your balance issues is established. Sometimes, therapies will be fairly basic. Certain antibiotics may be able to help, for instance, if an ear infection is causing your balance problems. More prolonged and intense intervention could be necessary in other circumstances.
A few of the most common treatments for balance issues include the following:
- Medication: In certain cases, over-the-counter or prescription medication can help you control and minimize symptoms.
- Positioning Exercises: Certain forms of vertigo can be managed with these exercises. One popular (and often effective) example is the Epley Maneuver.
- Lifestyle Modification: In certain cases, changing your lifestyle can help decrease your symptoms. For instance, eating more fruits and vegetables or quitting smoking could help control your symptoms.
- Vestibular rehab: These are exercises that can help improve your balance and, if effective, prevent falls.
- Surgery: There are certain scenarios where you will need to have an ENT do surgery.
Your balance of power
Your day-to-day safety, not to mention your general quality of life can be greatly affected by balance problems. If you’re unsteady because you are dizzy, it’s difficult to walk around your house never mind driving. Once your ENT figures out your balance problems, they will work towards an effective treatment.
You need to feel as if you’re back on dry land, so finding the cause of that persistent seasick feeling is the first step.