Hearing loss often occurs together with balance and dizziness symptoms indicating an underlying condition that requires your primary care doctor or audiologist’s attention.

How does balance work?

Balance problems cause dizziness that can lead to falls, which may cause broken bones and other injuries. Therefore it is useful to understand how balance works.

Balance is controlled through signals from your eyes, the inner ear, and the sensory systems of the body to your brain. This communication system is also known as the vestibular system.  Equilibrium, or a steady balance, makes it possible for us to walk, run, and move without falling.

Because it detects rotational movement of the head, the inner ear plays a critical role in how our balance works. Sensory hair cells in the inner ear provide information to the brain about head position when it is not moving. As the head moves, hair cells send nerve impulses to the brain. The nerve impulses are processed in the brain to help us know where we are in space or if we are moving.

What are causes of balance and dizziness problems?

If the inner ear is damaged or fighting an infection we will often experience disequilibrium, or imbalance. It is this disequilibrium that causes a feeling of dizziness and makes you feel as though you are spinning or moving when you are actually standing or sitting still.

In addition to inner ear problems, other causes of imbalance leading to the sensation of dizziness include:

• infections of the ear
• Meniere’s disease which changes the volume of fluid in your ear, causing balance problems, hearing loss, and ringing in the ears.
• head injury
• poor blood circulation
• alcohol
• aging
• chemical imbalance in the brain
• low blood pressure
• high blood pressure
• arthritis
• medications
• dehydration
• heat stroke
• excessive exercise
• motion sickness

What are symptoms of balance and dizziness problems?

The primary symptom of a balance disorder is dizziness, and/or the feeling that your surroundings are spinning. As a result, it can be difficult to walk without falling or the fear of falling.

Other symptoms of a balance disorder include:

• blurred vision
• mental confusion or disorientation
• nausea and vomiting
• feelings of depression, fear, or anxiety
• tiredness
• difficulty concentrating
• diarrhea
• blood pressure and heart rate changes

How are balance and dizziness problems diagnosed?

A doctor diagnoses dizziness and its underlying cause by performing a physical examination. He or she will ask questions about your dizziness, including when it strikes, in what positions, where the symptoms are located, and the severity.

The doctor may also refer you to an ear nose and throat specialist (ENT) and/or neurologist for further testing, or an audiologist for a hearing consultation. Depending on the suspected cause, a CT scan or MRI might be recommended.

How are balance and dizziness problems treated?

In treating your dizziness, your doctor will focus on the underlying health condition that caused the dizziness to start with. At-home treatments, lifestyle changes, and medication can generally eliminate or control the cause of dizziness.

Balance disorders relating to hearing loss can be assessed, treated, and rehabilitated by an audiologist who will conduct a hearing evaluation and other diagnostic tests looking for ringing or buzzing, earwax, and other underlying causes of imbalance that lead to dizziness.

For inner-ear issues, medications and at-home exercises can help manage balance. Meniere’s disease is treated with diet and occasionally behind-the-ear steroid injections or ear surgery. Migraines are treated with medications and lifestyle changes. Drinking plenty of fluids can help when dizziness is caused by excessive exercise, heat, or dehydration. Caffeine, alcohol, tobacco, and any substances that affect balance or trigger dizziness should be avoided while symptoms persist.

What is the outlook?

Balance problems and the sensation of dizziness caused by balance problems can be short-term or long-term depending on the underlying cause. If you have an ear infection or have just traveled by boat, the condition typically clears up in the short term, or with treatment. However, if the cause is unknown or the issues are a result of chronic conditions or aging, the symptoms may continue indefinitely. Most cases of dizziness clear up on their own when the underlying cause is treated.