Balance Problems - Treatment and Research

05/17/19 ·National Institute on Aging

Your doctor can recommend strategies to help reduce the effects of a balance disorder. Scientists are studying ways to develop new, more effective methods to treat and prevent balance disorders.

Balance disorders can be signs of other health problems, such as an ear infection, stroke, or multiple sclerosis. In some cases, you can help treat a balance disorder by seeking medical treatment for the illness that is causing the disorder.

Exercises for Balance Disorders

Some exercises help make up for a balance disorder by moving the head and body in certain ways. The exercises are developed especially for a patient by a professional (often a physical therapist) who understands the balance system and its relationship with other systems in the body. 

In benign paroxysmal positional vertigo, or BPPV, small calcium particles in the inner ear become displaced, causing dizziness. BPPV can often be effectively treated by carefully moving the head and torso to move the displaced calcium particles back to their original position. For some people, one session will be all that is needed. Others might need to repeat the procedure several times at home to relieve their dizziness.

Treating Ménière's Disease

Ménière's disease is caused by changes in fluid volumes in the inner ear. People with Ménière's disease can help reduce its dizzying effects by lowering the amount of sodium, or salt (sodium) in their diets. Limiting alcohol or caffeine also may be helpful. 

Medications such as corticosteroids and the antibiotic gentamicin are used to treat Ménière's disease. Gentamicin can help reduce the dizziness that occurs with Ménière's disease, but in some cases it can also destroy sensory cells in the inner ear, resulting in permanent hearing loss. Corticosteroids don't cause hearing loss, but research is underway to determine if they are as effective as gentamicin.

In some cases, surgery may be necessary to relieve a balance disorder. 

Treating Problems Due to High or Low Blood Pressure

Balance problems due to high blood pressure can be managed by eating less salt (sodium), maintaining a healthy weight, and exercising. Balance problems due to low blood pressure may be managed by drinking plenty of fluids, such as water, avoiding alcohol, and being cautious regarding your body's posture and movement, such as standing up slowly and avoiding crossing your legs when you’re seated.

Coping with a Balance Disorder

Some people with a balance disorder may not be able to fully relieve their dizziness and will need to find ways to cope with it. A vestibular rehabilitation therapist can help you develop an individualized treatment plan.

Talk to your doctor about whether it’s safe to drive, as well as ways to lower your risk of falling and getting hurt during daily activities, such as when you walk up or down stairs, use the bathroom, or exercise. To reduce your risk of injury from dizziness, avoid walking in the dark. You should also wear low-heeled shoes or walking shoes outdoors. If necessary, use a cane or walker and modify conditions at your home and workplace, such as by adding handrails. 

Current Research

Scientists are working to understand the complex interactions between the brain and the part of the inner ear responsible for balance. They are also studying the effectiveness of certain exercises as a treatment option for balance disorders. 

In a study funded by the National Institute on Deafness and Other Communication Disorders (NIDCD), researchers created a “virtual reality” grocery store. This virtual store is a computer-simulated environment that seems to be a physical place in the real world, designed so people with balance disorders can safely walk on a treadmill as they practice looking for items on store shelves. The goal is to help reduce a person's dizziness in confusing environments. 

NIDCD-supported scientists are also studying the use of a vestibular implant to stop a Ménière’s attack by restoring normal electrical activity in the vestibular nerve. This nerve conveys balance information to the brain. The device uses the same technology found in a cochlear implant, a medical device that currently provides a sense of sound to people who are deaf or hard-of-hearing. 

An NIDCD-supported clinical trial in benign paroxysmal positioning vertigo (BPPV) showed that repositioning maneuvers work well, and offered clinicians a range of choices in selecting the treatment best suited to each individual’s unique needs.