The balance system is made up of what your muscles and joints feel, what you see, and what you pick up by the balance part of the inner ear. Balance disorders disturb the balance system, which can cause unsteadiness, and dizziness and vertigo, as well as hearing problems.
Balance problems and the inner ear connection
Of course, the inner ear is part of the hearing system. However, it also makes up one-third of the balance system. The inner ear sends signals to the brain about the speed and direction of head movements and detects movements in a straight line.
Though balance disorders are sometimes caused by blood flow problems or systemic disorders, they are also often caused by disturbances in the inner ear due to bacterial or viral infections, certain medications, blood circulation, or aging. Balance disorders can also be associated with changes in the inner ear’s connecting nerves and the way the brain receives signals, often due to a disease or disorders like MS, or to head injuries.
Types of common balance problems
Benign paraxysmal positional vertigo is a balance disorder characterized by short episodes of dizziness and vertigo when moving the head in different directions, such as when getting out of bed or rolling over.
Labyrinthitis is a balance disorder that is caused by an infection of the inner ear. The labyrinth—a delicate structure inside the ear—becomes inflamed and affects both balance and hearing.
Ménière’s disease is another disorder affecting the inner ear, though much rarer. It causes hearing loss, a feeling of pressure in the ear, tinnitus, and vertigo.
Vestibular neuritis occurs when the vestibular nerve in the inner ear becomes infected and inflamed, and disrupts the sense of balance.
Symptoms of a balance disorder
Balance disorders are marked by the difficulty to maintain balance. A sensation of a spinning room, staggering when walking, nausea, vomiting, fear, and anxiety may also occur. In addition, some patients may feel dizzy from certain movements, such as walking on uneven surfaces or bending down, while others may experience headaches, muscle stiffness, tiredness, and neck stiffness due to the avoidance of natural movements to prevent dizziness from getting worse. The symptoms can last for long or short periods of times, depending on the specific balance disorder.
How to manage a balance disorder
The balance system depends on three parts: vision, muscles and joints, and the inner ear. If the inner ear is affected and a person has difficulty maintaining balance, they may become overly dependent on vision and the information that is received from joints and muscles. This can lead to adjustments in movement to compensate for the changes as well as the avoidance of certain head movements that increase nausea and dizziness. For example, a person may swivel their entire body rather than just their head. Unfortunately, these types of adaptations can lead to neck aches, headaches, fatigue, muscle stiffness, and a decrease in the brain’s ability to be retrained to adjust to the problem, causing symptoms to worsen.
The best way to manage a balance disorder is to participate in vestibular rehabilitation with an audiologist. This retrains the brain to once again recognize and process the vestibular system’s signals. It may involve desensitizing the balance system to the movements that create symptoms. After an initial assessment is performed, the audiologist develops a personalized treatment plan that includes home-based exercises that combine eye exercises with specific body and head movements. Increasing exercise and activities may also be recommended to increase stimuli tolerance and strengthen muscles. With consistent work, the coordination from the muscles and joints, the eyes, and the vestibular system will eventually occur, balance will improve, and symptoms will diminish or disappear.
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