Balance Difficulties

Many conditions can cause you to have problems with your balance, dizziness, or changing position. This can be caused by:

• Stroke
• Heart attack
• Heart failure
• Long Covid
• Breathing problems

Other conditions can also cause problems with your balance – for example, low blood pressure or blood sugar, problems with your ears, or problems with your nervous system.

What balance conditions are there?

Your balance may be affected by:

• Changes to your vision
• Damage to your inner ear
• Damage to the part of the brain which processes balance and position
• Low blood pressure or poor circulation
• Not enough oxygen in the blood (which can be caused by heart or breathing problems)

This can lead to:

• Dizziness
• Blurred vision
• Fainting or feeling faint
• Sickness and nausea
• Vertigo (a sense that the world is spinning around you)
• Falling or almost falling
• Confusion or disorientation
• Trouble with standing, walking, or doing certain exercises

Often, problems with balance can be improved by sitting or lying down. They may also get better with time, as your body adjusts to a new position.

Poor balance can cause problems with walking, exercise, and certain day-to-day tasks. It may increase your risk of falling and injuring yourself. However, you can learn exercises and skills which can help you to keep your balance and reduce the risk of falling.

You may also be able to adjust how you do activities to make balance issues less likely – for example, by doing exercises while sitting rather than standing, or having support when you are active.

PoTS (Postural Tachycardia Syndrome)

PoTS (Postural Tachycardia Syndrome) is a balance and posture disorder caused by problems with the nervous system. In PoTS, your circulation is affected by damage to the autonomic nervous system (the part of your nervous system responsible for unconscious movement and maintaining your body’s environment), meaning that blood gathers in the lower half of the body when you stand up or change position suddenly.

This means that the heart has to beat faster to push the blood back up into the head and chest. It may also mean that, for a time, your brain struggles to get enough blood flow.

Symptoms of PoTS hit when you stand up or sit up sharply, and include:

• Dizziness
• Blurred vision
• A much faster heart rate, or your heart “racing” in your chest
• Nausea or sickness
• Fainting
• Tiredness, fatigue, and exercise intolerance

PoTS is commonly caused by neurological and immunological problems like ME/CFS, Long Covid, lupus, stroke, or brain injury. It can also happen on its own.

You can find out more about PoTS and how to manage it through PoTS UK, a charity which offers help and support to people with PoTS.

Coping with balance problems

If your blood pressure is low, you may be able to reduce balance problems by:

• Increasing your salt intake (be aware that this may increase your risk of heart conditions)
• Drinking plenty of fluids, preferably water
• Doing exercises which improve blood flow, such as crossing and uncrossing your legs or clenching your fists

High blood pressure can also affect your balance. If this is the case, try to lower your salt intake if possible, exercise regularly, and take any medication you are prescribed to reduce blood pressure (such as statins).

Balance problems caused by an underlying condition, such as stroke or heart failure, can often improve when the condition itself is treated or begins to heal.

If you cannot treat your balance problems directly, there are still steps you can take to make falls and dizziness less likely:

• Speak to a health professional to find out whether there are exercises which may help you to build up your balance.
• If you feel dizzy, focus on your breathing. Breathe slowly and deeply, in through your nose and out through your mouth.
• Some people find that when they are dizzy or struggling with balance, it can help to pick a spot in the room and look at it, focusing on that spot only. This helps your brain to reorient itself.
• Remove clutter from your surroundings, especially from the floor. This can make a fall less likely.
• Avoid walking in the dark, where possible.
• Wear low-heeled shoes or walking boots outside.
• Having someone you trust nearby, especially when you walk a long distance or are doing exercise, can help – they can offer you physical support, and can also be a great emotional support if you are uncomfortable or frightened of falling.
• Stand up as slowly as you can, and support yourself where possible on nearby surfaces, such as chair arms or a desk or tabletop.
• Try to avoid rapid changes in light, such as going from a very dark room to a very bright one, as this can often trigger dizziness.
• Limit alcohol consumption, as well as the use of certain recreational drugs like cannabis or ecstasy, which can affect your balance directly.

If you have severe balance issues, you may need to talk to your health professional about whether it is safe for you to drive or operate other heavy machinery.

Aids and support

There are many types of physical aid that you can use to make falls less likely when you have balance problems: handrails, walking sticks or canes, walking frames, handles to help you get out of the bath, or shower seats so you don’t have to stand.

There are also types of furniture which you can choose which, while they aren’t necessarily “disability aids”, can make balance easier, especially when getting up. Look for chairs with armrests which you can use to support yourself while standing, and desks or tables which you can comfortably lean on if necessary.

You can find support for your balance issues from friends and family, but also through health professionals. Depending on the cause of your balance issues, you may get support through occupational therapy or physiotherapy.