I Feel Off-Balance Often: Can You Help?

If you’re struggling with your balance, you might experience symptoms such as dizziness, feeling like the room is spinning, sensing that you’re unable to control the position of your body, vision issues, and a general unsteadiness.

Balance issues have many causes, some of which may need medical care. At Modern Migraine MD board-certified neurologist, Risa Ravitz, MD, uses a patient-centered approach to diagnose the root cause of your balance troubles. 

Dr. Ravitz sees patients at her offices in Manhattan, NYC, Toms River, New Jersey, Aventura, Florida, and virtually in 13 states. By focusing on your whole health, not only your balance symptoms or condition, she helps improve your overall wellbeing while treating your dizziness.

Here’s a closer look at some causes of dizziness and other balance-related issues and the ways Dr. Ravitz can help.

About balance and balance problems

From needing a few moments when first standing in the morning or laying on the couch while watching a movie to feeling lightheaded in the heat or after skipping a meal, everyone experiences occasional moments of feeling off-balance.

For some people, however, balance problems persist and may appear without an obvious cause. To keep your sense of balance, many of your body’s systems must function independently and together. 

An issue with any of the many systems involved with balance, such as your joints, eyes, inner ears, nerves, heart, vascular system, muscles, or bones, can cause balance problems or a disorder to develop. Symptoms of a balance disorder may include:

• Vertigo (feeling like you’re spinning or moving)
• Dizziness or lightheadedness
• Feeling like you’re going to fall
• Unsteadiness
• Nausea or vomiting
• Feeling like you’re on a boat
• Vision changes
• Confusion
• Falling down
• Moving to one side when you walk

Balance disorders can also make you feel like you can’t tell or control where in space your body is positioned. 

Common causes of balance disorders

Trouble with your balance is a symptom of many underlying conditions. Some resolve on their own, while others require medical intervention. 

The most common cause of balance problems is a condition called benign paroxysmal positional vertigo (BPPV). BPPV develops when calcium crystals in your inner ear that help control balance move out of their normal position. This condition usually resolves on its own, though medications can help with the symptoms.

The second most common cause is vestibular neuritis, an inflammatory disorder. With vestibular neuritis, the nerves that help with balance in your inner ear don’t function normally because of inflammation. This condition typically goes away without medication after several days.

The third most common cause of dizziness is a condition called persistent postural-perceptual dizziness (PPPD). This disorder causes you to feel like you’re floating or rocking and tends to be worse when you stand or are in a visually complex environment, like a crowded shopping center. 

PPPD develops after your brain undergoes a stressful or alarming event, like a migraine, panic attack, depressive episode, or passing out. Your stress hormones activate your flight or fight response, which can change how your brain perceives motion and space. 

Other common causes of balance disorders include:

• Vestibular migraine (migraine with dizziness)
• Acoustic neuroma (a benign tumor) 
• Stroke or heart disease
• Circulatory issues (e.g., low blood pressure; hypertension)
• Ménière’s disease
• Spinal cord or brain injuries
• Swelling in the inner ear (labyrinthitis)
• Low blood sugar
• Dehydration
• Pregnancy
• Parkinson’s disease
• Multiple sclerosis
• Peripheral neuropathy
• Dementia and Alzheimer’s disease

You can also develop balance issues and dizziness from certain medications or because of different viral and bacterial infections. Because it’s nearly impossible to tell on your own what’s causing you to feel off balance, it’s always a good idea to see a medical provider if symptoms persist. 

How we help with balance disorders

Treatment for dizziness and balance disorders begins with an accurate diagnosis of your condition through a thorough assessment of your symptoms, medical history, current physical and mental health, different lifestyle factors (e.g., diet; exercise habits), and day-to-day activities.

To get to the bottom of your balance issues, Dr. Ravitz uses different assessment tools that evaluate your neurological health. She may also order additional tests and labs, including imaging studies, like MRIs or CT scans, and blood work. 

Based on the results of your diagnostic evaluation and tests, Dr. Ravitz creates personalized treatment recommendations. 

Reclaim your balance by scheduling an in-person or virtual appointment with Dr. Ravitz at Modern Migraine MD.