Balance problem needs closer look

Topeka Capital-Journal, The, Jun 23, 2009

Dear Dr. Gott: I am having trouble with my balance. What can you tell me about the cause?

Dear Reader: Your brief note is very difficult to answer. You don't give your age, gender, current medical conditions or medications, symptoms, how long you have had this difficulty or any other pertinent information. Therefore, I can only give you very brief, general background on some of the most common causes of balance difficulties.

First, see your primary care physician. He or she is your best resource for help and will be able to refer you to an appropriate specialist. Be prepared to answer several questions. The doctor will need to know how long you have been experiencing symptoms and which symptoms are causing the balance problems. Are you having abnormal skin or muscle sensations (such as pins and needles) in your feet or legs? Are you having difficulty focusing your eyes? Do you feel as though you are lightheaded, dizzy or faint?

Some of the most common reasons for balance difficulties include vertigo (an inner-ear malfunction), motion sickness, Meniere's disease, heart abnormalities, low blood pressure, medications, joint damage and anxiety disorders .

There are several tests that can be used to pinpoint the cause of the problem. Hearing tests, MRIs, CTs, blood work and even specialized eye testing may be used. Because there are several factors (eyes, ears, skin/muscle/nerves) that work together to help us balance, finding the specific cause may take time.

Most balance problems are related to the inner ear and respond to vestibular rehabilitation. This is an exercise program that aids patients in compensating for the loss of balance. Another beneficial step is to take courses for gait abnormalities. This can help sufferers regardless of the cause of their problem. Beyond these steps, treatment is related directly to the cause, so it is vital to be under the care of a physician .

Dr. Gott can be reached c/o United Media, 200 Madison Ave., 4th floor, New York, NY 10016.

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