Feeling dizzy, lightheaded or unsteady on your feet is more than an annoyance. Balance problems make everyday tasks harder and raise the risk of a fall. The good news is that many balance problems can be improved with the right exercises. Here's how balance works, what can go wrong, and how a physical therapist can help.
What keeps you balanced
Staying upright depends on several systems working together:
- The inner ear, which senses head movement and position
- Your eyes, which tell you where you are in the room
- Sensation in your feet and joints, which tells you where your body is and what you're standing on
- Muscle strength and reaction time, which let you catch yourself when you start to tip
When one of these systems isn't working well, the others have to work harder, and balance suffers.
Common causes of balance problems
- Inner ear problems, including benign paroxysmal positional vertigo (BPPV), a common cause of brief spinning when you roll over in bed or look up
- Nerve damage in the feet (peripheral neuropathy), often related to diabetes
- Weak leg and hip muscles
- Parkinson's disease, stroke and other neurological conditions
- Side effects of some medications
- Changes in vision
- Long periods of inactivity, such as after an illness or hospital stay
How a physical therapist evaluates balance
Your therapist will ask when your symptoms happen and what makes them better or worse. Then we test your strength, walking, reaction time and how well you balance with your eyes open and closed and on different surfaces. If your symptoms suggest BPPV, we can test for that too. The results show which systems need the most work.
How physical therapy helps
- Balance training that safely challenges your body so it gets better at staying steady
- Strengthening for the legs, hips and core
- Walking practice, including turning, stairs and uneven ground
- Vestibular exercises that help the brain adapt to inner ear problems and reduce dizziness
- Repositioning maneuvers for BPPV, which can often relieve symptoms quickly
- Guidance on canes and walkers when they would help
Why balance therapy at home works
Most falls happen at home. When therapy takes place there, we can practice on your own stairs, rugs and bathroom floor, and look for hazards like poor lighting or loose cords. Small changes, like a grab bar or a night light, can make a big difference.
Other providers who can help
Balance often involves more than one part of the body. Your therapist may suggest checking in with:
- An eye doctor, to make sure your vision is up to date
- Your primary care doctor, to review medications that may affect balance
- An ear, nose and throat doctor, if an inner ear problem needs further testing
When to get help right away
Call 911 if dizziness comes on suddenly along with weakness, numbness, facial drooping, trouble speaking or a severe headache. These can be signs of a stroke.
This article is general information, not medical advice. Talk with your doctor about any new or worsening dizziness.
Get help at home
UPT Services provides in-home balance therapy and fall prevention across Northeast Philadelphia, Bucks County and Montgomery County, including a walk-through of your home to spot hazards. We accept Medicare Part B. Call (215) 760-8229 to get started.