Balance

An illustration of a businessman walking a tight rope with a giant tangle in it

5 Tips for Living with Balance Problems

Get back on sure footing with these easy ways to prevent falls

If you live with balance issues, you’re not alone. About 35% of U.S. and Canadian adults 40 or older are no strangers to them. Let’s take a look at what they are and some simple ways to ease their burden.

 

The Basics of Balance

Is It a Balance Problem?

How do you know if what you’re experiencing is a one-off or a true balance problem?

Some people have difficulty with tree pose in yoga class. Others aren’t so hot on a unicycle. These are not balance problems — these are illustrations of how each of us has different skills.

Do you feel unsteady walking from a carpeted floor to a hardwood floor? Does a trip to the supermarket make you light-headed? These are examples of what life is like for someone with a balance problem. Simple daily tasks become a battle.

You might be surprised that so many adults have firsthand experience with this sort of problem. But a look at how complicated your balance system is might shed some light.

 

Your Balance System

Your ability to achieve and maintain balance depends on your brain coordinating input from three sources, integrating the input, and sending output to your eyes and muscles. The three sources are:

  • Your eyes send information to your brain about where you are relative to the objects around you.
  • This ten-dollar word is simply your body’s ability to sense movement, action, and location. Your skin, muscles, and joints constantly send messages to your brain about what position you’re in and what you’re doing.
  • Vestibular system. This is named for the vestibule, a part of your inner ear. This system is responsible for providing your brain with information about your head’s motion, equilibrium, and spatial orientation. There are many small structures that all work together to constantly send your brain information.

Your brain sorts all this information and combines it with information from the parts of your brain responsible for coordination, thinking, and memory. Then it sends messages that control the movements of your eyes, head and neck, torso, and legs to ensure continued balance.

When your balance system works properly, you see clearly while moving, stay oriented with respect to gravity, know your direction and speed, and automatically make posture adjustments to maintain stability.

 

Causes of Balance Problems

For many people, balance problems set in because of age-related issues such as cardiovascular disease, stiff or damaged joints, or an autoimmune condition. But the inner ear is the most common source of these disorders for all ages, from fluid imbalances to bone damage.

Symptoms range from short and mild to chronic and debilitating. Some common ones are general unsteadiness, vertigo (a spinning sensation), noise or light sensitivity, nausea, coordination problems, and concentration or memory issues.

 

Diagnosing Balance Issues

Many systems and sources contribute to balance — and interact with yet other systems. That’s why diagnosis is often not straightforward. Your first step, however, should be an audiologist, who might perform any combination of the following.

 

Videonystagmography (VNG)

This test tells your provider if your brain is getting conflicting messages from your eyes and inner ears. You wear goggles that monitor your eye movements and perform tasks such as following a target and placing your head and body into different positions.

 

Rotation tests

There are different kinds of rotation tests, but they all provide information about how well your inner ears and eyes work together. You wear goggles or electrodes and your head moves (usually slowly) while your audiologist monitors your eye movements.

 

Video head impulse test (vHIT)

This also provides information about how well your inner ears and eyes work together. You wear goggles or electrodes, your head moves, and your audiologist monitors your eye movements. The major difference is the head movements are very slight and faster.

 

Vestibular evoked myogenic potential (VEMP)

VEMP testing evaluates whether certain balance structures and associated nerves are intact and working normally. The test uses adhesive, skin-surface electrodes on the neck and around the eyes as well as earphones like the ones during a hearing test.

 

Dynamic visual acuity (DVA) testing

DVA testing evaluates your ability to use your inner-ear balance system while your head moves. You identify a target on a computer screen while your head is still and then with your head moving.

 

Tips for Living With Balance Issues

If you’ve been diagnosed with a balance problem — or you’re starting to think this all sounds familiar in your life — let’s look at five ways to ease your balance burden.

 

Keep Rooms Clutter-Free

Cutting down on clutter means far less likelihood of tripping. The following will go a long way toward preventing falls:

  • Keep walking paths and stairs free of books, clothes, shoes, and children’s or pets’ toys
  • Ensure carpets are secured and put no-slip strips on carpet-free floors
  • Keep electrical cords out of the way
  • Arrange your furniture to ensure clear walking paths
  • Keep walking areas outside clear of children’s and pets’ toys, tools, and fallen branches

 

Use Assistive Devices

Having the right fail-safes in place can make all the difference in one moment of unsure footing:

  • Make sure there are secure handrails on both sides of all stairs
  • Place easy-access grab bars near toilets, tubs, and showers as well as nonskid mats on surfaces that get wet
  • Keep a night light and flashlight close to your bed
  • Use a reach stick to grab something that’s out of reach
  • If you decide to try a cane or walker, ensure it’s the correct size for you

 

Dial in Your Diet

Ménière’s disease and hydrops are caused by fluid imbalance in the inner ear. Modifying or eliminating certain substances from your diet can help maintain fluid stability. Check with your doctor before making big dietary changes — discuss the proper approach to:

  • Spacing food and fluid intake evenly throughout the day
  • Reducing salt and sugar intake
  • Eliminating caffeine, nicotine, and alcohol consumption
  • Adjusting or eliminating any supplements that might affect your symptoms

 

Dare to Dine Out

For those with a vestibular disorder, busy settings such as restaurants and supermarkets can be difficult to handle. The mazes of tables, bright lights, tile or carpet patterns, and turning your head to talk can make you dizzy or disoriented. And it saps a lot of energy.

But with some adaptations, you can still eat in relative comfort:

  • Avoid rush hour and choose a restaurant with quiet background music.
  • Seek out carpeted floors without busy patterns and avoid shiny surfaces, ceiling fans, and busy wallpaper.
  • Download a menu in advance to plan your meal ahead of time.
  • Choose restaurants that will cater to your dietary needs.
  • Sit in the corner away from the bustle, kitchens, and cash registers.

Fine-tune Your Footwear

To help you balance, your feet and ankles constantly gather information about your body position and movement. That’s why it’s crucial for those with balance issues to choose the right footwear:

  • Ensure your shoe’s heel is 2.7 cm high or less
  • Wear shoes with a hard, thin midsole
  • A treaded sole and a treaded, beveled heel helps prevent slipping
  • If you tend to slide your feet, wear smooth-soled shoes instead
  • Walking barefoot or in socks or slippers might seem like a good idea, but studies have shown those with balance problems do best with shoes, even around the home

If you — or someone you love — have seemed a little unsteady, contact us!

An illustration of a coffee cup on a saucer filled with coffee

Q&A: Does Caffeine Affect Hearing and Balance?

Q: Is caffeine harmful?

A: This is one of the most loaded questions about everyday health. Many studies have been conducted on the effects of caffeine on the body. Some of these effects are positive and some are negative. Some studies suggest a correlation between moderate caffeine consumption and lower risks of some diseases, while others have shown the opposite. Different lifestyle and genetic factors determine whether caffeine is a healthful substance for you personally, so always check in with your physician before making decisions about which drugs to ingest and how much to use. Caffeine can also interact with certain medications and supplements, so it’s always a good idea to discuss your intake with a doctor if you have questions or concerns.

Q: How does caffeine impact hearing?

A: Frustratingly, the jury is still out on this, but here’s what we know so far:

One animal model study demonstrated that caffeine may impair the body’s ability to recover from acoustic trauma. Typically, the effects of acoustic trauma are temporary and resolve days or weeks after exposure, but test subjects given daily doses of caffeine and subsequently exposed to loud noise recovered their hearing more slowly than those without caffeine. These findings are important to consider, because if the same results are observed in humans, it could change how we approach hearing safety in a variety of environments.

Another study using data from the Korean National Health and Nutrition Examination Survey discovered that tinnitus was less prevalent in daily coffee drinkers in the 19–39 and 40–64 age groups than in their peers who rarely drink coffee. It also suggested that brewed coffee may have preventative effects on hearing loss and tinnitus, but that other coffee preparations may induce tinnitus in some age groups.

A UK study found that coffee consumption is associated with a lower risk of disabling hearing loss in men. It is thought that the antioxidant and anti-inflammatory properties of coffee are responsible, rather than caffeine content, since the result held true for both caffeinated and decaffeinated coffees. Interestingly, female coffee drinkers did not receive the same benefit.

Q: Does caffeine affect balance?

A: Possibly. According to a study from 2021, consumption of caffeinated beverages may enhance postural stability and voluntary motor control. Because caffeine is a stimulant, it increases attention, which can have an effect on a person’s balance. We’re not yet sure if caffeine affects the vestibular system directly, or if caffeine’s effect on the central nervous system is responsible for observed improvements in the posture and balance of the test subjects. More research is needed to understand these results.

If you’re experiencing hearing loss, tinnitus, or balance problems, please don’t wait. Contact us today to get your questions answered or to schedule an exam. We’re HEAR to help!

an illustration of a dizzy woman

Q&A: Is My Dizziness Normal?

Q: Why am I dizzy?

A: We receive this question often. Dizziness is a very common symptom that can spontaneously occur and resolve without any underlying conditions. When there is an underlying condition, it can be as simple as hunger or as serious as a stroke. This is why looking up your symptoms online can lead to a heap of unnecessary anxiety! Luckily, there are some additional symptoms to watch for when determining what’s really going on. These are the most common causes of dizziness:

Vestibular Disorders

According to Johns Hopkins, 85% of dizziness and vertigo episodes are caused by physiological dysfunction within the inner ear. This typically occurs because there has been an unexpected shift in the fluid of the semicircular canals above the cochlea, making you feel off-balance or as if you’re in motion. One major clue that you’re dealing with a vestibular disorder is if your dizziness is accompanied by hearing loss or ringing in the ears. Fortunately, these disorders are highly treatable. Audiologists and ENTs can run a battery of tests to determine the exact cause of your dizziness and provide an effective treatment plan, so don’t hesitate to get it checked out.

Hypoglycemia

Whether you’re taking medications to lower your blood sugar or simply haven’t eaten for a while, a dip in glucose can make you feel surprisingly weak and lightheaded. Hypoglycemia is defined as any blood sugar reading under 70 mg/dl, but many people experience dizziness at levels above that, depending on how their bodies respond to hunger. If your dizziness resolves after having a snack, that’s a good indication that you were low on energy and needed a boost. Patients living with diabetes should pay special attention to their dizziness, as medication adjustments may be needed.

Hypotension

Similar to the previous item on this list, dizziness is one of the top symptoms of low blood pressure. This too can be caused by medication, though dehydration is the likelier culprit. When the body loses too many fluids, blood volume decreases, leading to hypotension. Many people also experience a drop in blood pressure after suddenly changing positions or spending long periods of time on their feet. This condition is known as orthostatic hypotension and is usually mild. Replenishing your fluids and resting in a comfortable position should help.

Anxiety

A keyed-up nervous system can cause pretty severe dizziness and disorientation. It’s even possible to experience fainting spells during an anxiety attack. This may happen because of a frightening event, post-traumatic stress, or an accidental triggering of the body’s fight-or-flight response. Rest assured that many, many people live with chronic anxiety. However, if you suspect your dizziness is the result of emotional distress, it’s important to rule out other causes first. Be sure to discuss testing and treatment options with your physician.

Q: When should I tell a doctor about my dizziness?

A: As soon as you feel it’s more than a passing annoyance. While dizziness is one of the most common patient complaints and is usually nothing to worry about, it can lead to falls. The older you are, the more dangerous falls become, so take dizziness seriously if it occurs often or disrupts your daily life. The bottom line is: You know your body better than anyone else. When in doubt, seeking a professional opinion is never a bad idea. Always get immediate medical attention if your dizziness is severe or accompanied by any of these signs of a stroke or heart attack:

  • Blurred vision
  • Slurred speech
  • Chest pain or discomfort
  • Numbness or tingling
  • Impaired mobility
  • Sudden confusion
  • Loss of consciousness

Did You Know?

• Dizziness is the third most common complaint (after headaches and lower back pain) in all age groups.
• Dizziness is the number-one complaint from people who are 70 and older.
• 85% of dizziness & vertigo is caused by inner-ear dysfunction.
• 25% of migraine sufferers report vertigo as a symptom.
• Most patients visit 4 to 5 physicians before a correct diagnosis is made.
• Falls are the leading cause of death for people who are 65 and older.


If you’re suffering from dizziness or think you may be experiencing a vestibular disorder, please don’t wait. Contact us today to get your questions answered or to schedule an exam. We’re HEAR to help!

How Head Injuries Impact Hearing and Balance

How Head Injuries Impact Hearing and Balance

The force of a traumatic brain injury (also known as a TBI, concussion, or head injury) can damage or displace the delicate bones of the inner ear, rupture the eardrum, and disrupt parts of the brain responsible for auditory processing. A persistent ringing, buzzing, or hissing sound may occur in one or both ears, and some TBI patients also report hyperacusis, which is an extreme sensitivity to sound. Additionally, injuries to the inner ear can impact the vestibular system, which is made up of tiny fluid-filled canals that send signals about your head’s position to the brain. Dislodging parts of the vestibular system leads to spatial disorientation, dizziness, difficulty in finding footing or judging distances, and a feeling that you or your surroundings are in motion.

 

How Common Are They?

The Northern Brain Injury Association estimates that 452 people suffer a serious brain injury every day in Canada. Of those injuries, up to 50% involve hearing loss or sudden-onset tinnitus. TBIs are especially common among survivors of car collisions, contact sports, accidental falls, and domestic abuse.

 

Is the Hearing Loss Permanent?

Fortunately, most cases of hearing loss resulting from a TBI resolve on their own within a few months. As the brain heals, auditory processing will recover. If a bone fracture or displacement has occurred, corrective surgery will usually fix the problem. Occasionally, hearing loss from a TBI is permanent, such as when the cochlea is irreparably damaged, but this is rare.

 

Treatment

A traumatic brain injury must be treated by a physician right away. Because of the risk of hematoma, or bleeding in the brain, imaging tests are necessary to assess the extent of the damage. If the injury to the ear is physical, this will often be apparent following a CT or MRI scan. Neurological causes are a bit harder to diagnose but can be identified through a critical evaluation by an audiologist. If you have been impacted by a traumatic brain injury and notice any changes in your hearing or equilibrium, make an appointment with an audiologist as soon as possible. They will perform a series of tests to assist in determining your treatment options.

 

Because hearing and balance are so integral to our ability to communicate, it is important to distinguish between hearing loss and cognitive disruptions following a TBI.

 

Prevention

To prevent TBIs, always wear helmets or other protective headgear when playing potentially hazardous sports and engaging in recreational activities such as cycling, skateboarding, and horseback riding. While driving or riding in a vehicle, always wear your seatbelt. During the winter, hold on to railings and step carefully in icy conditions to avoid losing your footing. And as simple as it may sound, be careful when entering or exiting the shower. Many people slip and fall on slick bathroom tiles every year. Prevention is always going to be the best defense against TBI-induced hearing loss.

 

If you or someone you know has suffered a head injury and is experiencing hearing difficulties, please contact our caring team today!

Are Balance Problems Related to Hearing Loss?

Are Balance Problems Related to Hearing Loss? There’s a Definite Possibility!

It’s common for people with hearing loss to have balance issues, and vice versa.

This phenomenon might even affect you or a loved one. Do they occur together as a coincidence, or are hearing and balance actually related? It turns out the answer is, “It depends.” Let’s look at some basics first.

The Inner Ear

The inner ear is also known as the bony labyrinth, and it consists of both the cochlea and the vestibular system.

  • The cochlea (hearing): The cochlea is where sound signals are captured, converted to electrical signals, and sent to the brain to be interpreted as sound.
  • The vestibular system (balance): This comprises three bony canals and two pouches. These work together to tell your brain where your head is in space, as well as when and how it’s moving.

 

Hearing and Balance Problems

Both hearing and balance depend heavily on the status of your inner ear, so it makes sense that what affects one may affect the other. But let’s look at some examples to see how parts of the inner ear can be affected to cause different conditions.

Noise-induced hearing loss

Noise-induced hearing loss is an example of hearing loss with no inherent balance problem. It is caused when the hair-like hearing cells in your cochlea are damaged. This damage means less (or distorted) sound input is sent to your brain. Because it’s only in your cochlea, this damage usually doesn’t affect your balance.

Benign paroxysmal positional vertigo

Usually abbreviated BPPV, this is an example of a balance problem with no hearing loss. It causes sudden, brief spells of vertigo (a false feeling of spinning) and may be triggered by certain head movements.

What causes BPPV? The two pouches in your vestibular system hold a gel filled with crystals. These crystals react to gravity and help you understand when you’re speeding up and slowing down. But sometimes a crystal gets loose and floats into one of the three bony canals. When enough of these crystals end up in a canal, the fluid in that canal doesn’t flow as it should, and incorrect balance signals get sent to your brain. Because this doesn’t involve your cochlea, it doesn’t affect your hearing.

Ménière’s disease

Ménière’s disease is an example of hearing loss and balance problems that are often related. In fact, those are the chief symptoms — hearing issues in conjunction with balance problems.

This condition results from a buildup of endolymph, a fluid that fills the chambers and tubes of your inner ear. The increased pressure from the buildup confuses the hearing and balance receptors throughout, resulting in incorrect signals getting sent to the brain.


It’s Not a Slam Dunk

Many things lead to hearing loss. Many things lead to balance issues. As specialists in all things inner ear, an audiologist is uniquely suited to consider all your symptoms and determine which parts of your inner ear are causing you trouble. If you’re worried about a balance problem — yours or a loved one’s — contact us today to schedule a consultation.

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