Imbalance: What Does it Mean When Your Equilibrium is Off?

Balance Problems? What You Need to Know About Loss of Equilibrium

Welcome to the Symptom Guide Regarding Imbalance or Unsteady Gait

We’re sorry to hear you’re having this problem.

This symptom guide is designed for persons who have noticed balance problems or unsteadiness while walking.

Please keep in mind that this guide cannot replace a face-to-face evaluation with a health professional. It is meant to provide helpful information while you are awaiting further evaluation, or to supplement what you may have already learned after medical evaluation.

In this guide, you’ll be asked a series of questions that will guide you through some of the most common reasons for balance problems; however, it won’t cover every cause.

So, if none of the conditions covered in this guide seem to apply to you, keep in mind that sometimes no cause is found. Or, you may have a rare cause of imbalance that’s not covered here.

Let’s Begin

The first questions are aimed at the possibility of a serious or dangerous cause of imbalance or unsteady gait.

Did your balance problems begin after a head injury?

Or did they develop along with any of the following?

  • A severe headache
  • Weakness on one side of the body
  • Slurred speech
  • Inability to walk
  • Tremor
  • Trouble swallowing

Yes, one or more of those is true.

No, none of those is true for me.

Okay. The next questions deal with the possibility of motion sickness as a cause of your symptoms.

Did your imbalance begin after riding in a car, boat, or plane? Have you also had nausea, vomiting, and sweating?

Yes, that sounds like my situation.

No, that doesn’t sound familiar.

You could have a serious brain injury or a brain disease, such as stroke, Parkinson’s disease, or a brain tumor. It could also be a less serious brain problem, such as a migraine (especially if headache is prominent).

Contact your doctor right away to be evaluated.

Would you like to quit now or continue with this guide?

I’d like to continue with this guide.

I’d like to quit now.

Glad you decided to continue, but do get to your doctor for evaluation.

The next questions deal with the possibility of motion sickness as a cause of your symptoms.

Did your imbalance begin after riding in a car, boat, or plane? Have you also had nausea, vomiting, and sweating?

Yes, that sounds like my situation.

No, that doesn’t sound familiar.

Okay, good.

Do you have any of the following symptoms along with your imbalance?

  • Vertigo (a sensation of spinning) in certain positions or when you turn your head
  • Intermittent hearing loss
  • A sensation of fullness in the ears

Yes, one or more of those is true.

No, none of those apply to me.

Okay. Your imbalance may be due to motion sickness. The good news is that it tends to get better over time once you are no longer moving.

A couple of tips that might help decrease motion sickness:

  • Don’t read while riding in a car
  • Focus on an object in the horizon when you are on a boat

Do you have any of the following symptoms along with your imbalance?

  • Vertigo (a sensation of spinning) in certain positions or when you turn your head
  • Intermittent hearing loss
  • A sensation of fullness in the ears

Yes, one or more of those is true.

No, none of those apply to me.

Okay. That makes an inner ear problem less likely. Just a few more questions.

Did you start taking any medications around the time that your imbalance began?

Yes, that is true for me.

Nope, I’m not taking any new medicines.

Alright. Your imbalance could be due to an inner ear problem, such as Meniere’s disease or benign positional vertigo. A viral infection or ear injury could also cause your symptoms. These conditions tend to get better over time or after treatment. See your doctor for evaluation and to learn about specific treatments.

Did you start taking any medications around the time that your imbalance began?

Yes, that is true for me.

Nope, I’m not taking any new medicines.

Okay, good. But it’s probably a good idea to review any medicines you are taking with your doctor to see if one or more of them might be contributing to your imbalance.

Have you had any of the following symptoms?

  • Burning pain, tingling, or numbness in one or both legs
  • Persistent twitching in the muscles
  • Significant neck pain or very limited neck motion

Yes, one or more of those is true.

No, none of those is true for me.

Okay, it’s possible that one of your medications is causing or contributing to your imbalance. Alcohol and over-the-counter medicines can affect balance also, either alone or when interacting with your other medicines. Talk to your doctor about the possibility that one or more of your medicines could be causing imbalance. He or she may suggest you switch to something else or stop the medicine to see if you improve. But don’t make any changes without checking with your doctor first.

Would you like to quit now or learn about other possible reasons for your imbalance?

I’d like to continue with this guide.

I’d like to quit now.

Good, let’s move on. The next question addresses the possibility of a nerve problem as a cause of imbalance.

Have you had any of the following symptoms?

  • Burning pain, tingling, or numbness in one or both legs
  • Poor coordination
  • Persistent twitching in the muscles
  • Significant neck pain or very limited neck motion

Yes, one or more of those is true.

No, none of those is true for me.

Good, that makes nerve disease (neuropathy) an unlikely cause of your poor balance.

Do you have trouble getting up out of a chair without using your hands?

Yes, that’s tough for me to do.

No, I have no trouble getting out of a chair.

Your answer suggests that nerve disease (neuropathy) could be the cause of your poor balance. For example, people with diabetes may develop neuropathy as a complication, and that can affect balance. Other conditions affecting nerves include neck arthritis, vitamin B12 deficiency, amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease), inherited conditions, and multiple sclerosis.

Make sure to tell your doctor all of your symptoms so that you can be properly evaluated and treated.

Would you like to quit now or learn about other causes of imbalance?

I’d like to continue with this guide.

I’d like to quit now.

The next question addresses the possibility of muscle disease as a cause of imbalance.

Do you have trouble getting up out of a chair without using your hands?

Yes, that’s tough for me to do.

No, I have no trouble getting out of a chair.

Good, that makes muscle disease less likely as a cause of imbalance.

Just one more question.

Do you have joint pain, a sense of instability, or knee locking in one or both legs?

Yes, that’s true for me.

No, I don’t have those symptoms.

You could have muscle disease (myopathy) as a cause of your imbalance. There are many causes of myopathy, ranging from infections to autoimmune diseases. A detailed examination and muscle tests are necessary to diagnose myopathy, so see your doctor and be sure to mention all of your symptoms, including the part about the chair.

Just one more question.

Do you have joint pain, a sense of instability, or knee locking in one or both legs?

Yes, that’s true for me.

No, I don’t have those symptoms.

Okay, that makes a joint problem less likely as a cause of your balance trouble.

Click here to complete this guide.

Okay, you could have a joint problem as a cause of your imbalance. For example, arthritis, torn cartilage, or an injured ligament can cause problems with balance. A joint examination, and perhaps some imaging tests, will likely be necessary to establish the diagnosis. Treatment depends on the specific diagnosis, but arthritis and other joint conditions causing balance problems tend to be quite treatable.

Click here to complete this guide.

Thank you for using this symptom guide. We hope it was helpful and that your balance problem improves soon.

Please Remember:

  • There are many causes of imbalance or unsteady gait; while some of them increase in frequency as we age, poor balance is not an inevitable part of aging.
  • Consider medications as a potential cause of poor balance; check with your doctor or pharmacist about this possibility.
  • Many of the common causes of poor balance are reversible or treatable, but the treatment depends on the cause. So, be sure to get your symptoms checked out by your doctor.

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