Since balance is regulated in the inner ear, this is the location where vertigo usually originates.

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Although vertigo—a “spinning” sensation—is a fairly common complaint among older adults, it is not an inevitable part of aging. There are many possible causes, and it’s important to be evaluated by a doctor who can determine the cause and recommend appropriate treatment. Vertigo caused by vestibular (balance) system disorders can lead to falls in older adults, so although the condition may be benign, the consequences can be hazardous.

Tell Your Doctor About Your Balance Problem

Many people fail to report episodes of dizziness or  poor balance to their physicians, often because they are afraid that something very serious, such as a tumor, is causing their symptoms. But underlying causes such as this are rare (and consulting your doctor can help rule them out). Discussing the problem with your doctor also can arm you with strategies to safely tackle your poor balance.

Benign Paroxysmal Positional Vertigo

Since balance is regulated in the inner ear, this is the location where vertigo usually originates. A condition called benign paroxysmal positional vertigo (BPPV) is caused by crystals (microparticles of calcium, or “otoconia”) that form in the balance canals of the inner ear. People with BPPV typically complain of brief spells of intense spinning that are provoked by turning in bed, bending down, or looking up at the ceiling. The problem is diagnosed in the office and treated by a simple procedure named the Epley maneuver. This is an exercise done with the assistance of a doctor or physical therapist, and it involves your head being moved into certain positions while you recline in a chair or lie down. The goal is that the crystals will slip back into another area of the inner ear where they can be reabsorbed, relieving your vertigo. Some people gain relief after only one treatment but typically the procedure may need to be repeated several times over several days. Your doctor also may demonstrate how to do the movements at home.

What If It Isn’t Vertigo?

Another condition that can affect your balance is vestibular neuritis (also known as acute labyrinthitis). This is caused by a viral infection of the inner ear, and it manifests as a sudden, unexpected attack of vertigo that can last from a few days to a few weeks. Vestibular neuritis usually resolves completely, but occasionally, patients are left with chronic poor balance that may be treated by vestibular physical therapy (VPT).

VPT is essentially “balance therapy,” and is designed to help you learn compensatory techniques you can fall back on if you experience dizziness that affects your balance. It doesn’t focus just on poor balance related to the inner ear, but also takes into account poor balance caused by vision problems and/or issues with your sense of touch (these are factors your doctor will take into account when you discuss your balance issues with him or her).

Medications are another possible factor in poor balance—for example, drugs that treat high blood pressure can cause you to become dizzy and lose your balance, particularly if you rise too quickly from a sitting or prone position. If you’re experiencing this side effect from your meds, tell your doctor—it’s possible that adjusting the dose might alleviate the problem. Medications that usually don’t cause balance problems can cause dizziness if they interact with other drugs, or with alcohol. As a precaution, provide your doctor with a complete list of the medications you take.