Your ears are just as important as your brain, muscles, nerves, and eyes in maintaining your balance. An inner ear structure called the vestibular system, or labyrinth, tells your brain your head is rotating or that you’re standing, sitting, lying down, or moving. Without these vestibular system functions, you’d struggle to control your balance and posture. It’s no surprise, then, that inner ear damage can lead to balance issues. (If you’ve heard of vertigo, you may be surprised to learn that this condition is actually an inner ear disorder.)
When signals from these inner ear structures are sent improperly, your brain may think you’re spinning or moving when you’re immobile. You might also feel like you’re tipping over when you’re walking normally. These improper signals can be a result of head injuries, aging, ear infections, and some other causes. Theoretically, they can also result from hearing loss. Learn more below about how your hearing health affects your sense of balance and your risk of falls.
In theory, sensorineural hearing loss – which stems from damage to the hair cells in your ear canal and middle ear – can affect your balance. These hair cells receive the sound waves that your inner ear eventually converts to electrical signals that your brain understands as sound. However, the high amplitude of loud sounds can destroy these cells, which your body can’t regrow. The result is hearing loss.
However, balance is a function of the inner ear, not the ear canal and middle ear. The vestibular system has its own hair cells, and the inner ear does amplify sounds that the ear canal’s hair cells pick up. As such, the same loud sounds that damage the hair cells in your ear canal can theoretically harm the hair cells in your inner ear. Extensions of these inner ear hair cells called stereocilia are responsible for signaling motion and balance to your brain.
Through this anatomical pathway, it’s possible for hearing loss to worsen your sense of balance and increase your risk of falls. In fact, most audiologists have worked with many people experiencing both hearing loss and balance issues. However, most audiologists would likely point to other aural issues as the main culprits of balance problems.
Balance disorders that are related to healthy aural function include:
- Benign paroxysmal positional vertigo (BPPV). If you’ve ever felt dizzy upon bending down or hitting your head, you’ve experienced BPPV. This condition is the result of a substance called otoconia flowing into the vestibular system from other inner ear structures. This otoconia flow can affect the parts of the vestibular system responsible for balance and thus lead to temporary vertigo. Although BPPV episodes are typically intense, they rarely last long, and as their name suggests, they’re benign.
- Ménière’s Disease. This inner ear condition, with which 615,000 Americans – primarily between ages 40 and 60 – are diagnosed, can cause severe vertigo. For some people, this vertigo can be intense enough to cause a complete loss of balance that leads to a fall. These intense bouts of vertigo often follow periods of tinnitus or muffled hearing.
- Labyrinthitis. As its name suggests, this condition describes an inflammation of the labyrinth (vestibular system). With the system inflamed, its organs cannot function properly, leading to balance issues. This inflammation typically stems from an upper respiratory infection and may subside once the infection resolves.
- Vestibular neuronitis. Like labyrinthitis, vestibular neuronitis is the result of an infection or inflammation. Unlike labyrinthitis, vestibular neuronitis only affects the vestibular nerve, not the whole labyrinth. However, since the vestibular nerve connects the labyrinth to the brain, any problems with it can lead to balance issues that increase your fall risk.
- Perilymph fistula. This condition describes the movement of fluid from the inner ear into the middle ear. This fluid displacement can alter your sense of balance, and it often stems from head injuries, ear infections, physical exertions, or anything that might make your ears pop. However, some people are born with this condition and must work with audiologists and vestibular therapists to make living with it possible.
Audiologists often take the following steps to address the vestibular system issues underlying poor balance:
- The Epley maneuver. Your audiologists may walk you through these movements, which are intended to dislodge otoconia from your vestibular system if you have persistent BPPV. Often, one appointment with an audiologist solves this problem. In other cases, repeat visits may be necessary.
- Diet and lifestyle changes. Most audiologists recommend that those with balance issues, especially if caused by Ménière’s Disease, eat healthier and quit smoking. These changes can correct your inner ear’s operation and help improve your balance.
- Medication. If the anatomical cause of your vertigo isn’t fully clear, audiologists may prescribe medications to treat your symptoms in a non-invasive way. These medications generally include anti-nausea drugs, corticosteroids, or anti-vertigo drugs.
- Ear surgery or vestibular therapy. In severe cases of balance loss, audiologists may refer you to an ear, nose, and throat (ENT) surgeon or a vestibular therapist. Surgery is, of course, an invasive option best left as a last resort. Vestibular therapy is non-invasive, but it’s also a substantial commitment that should only be taken after nothing else works. No matter what, see an audiologist first.
Whether you go through long days of in-and-out dizziness or just occasionally feel like you’re about to fall, audiologists are uniquely qualified to help. And here at I Love Hearing, our audiologists have decades of experience working with the inner ear and figuring out how its dysfunction is affecting your life. That, of course, includes balance issues.
Addressing balance issues is far from our only expertise. We also specialize in treating hearing loss and finding the right hearing aids for anyone with diminished hearing. In fact, if you bring someone with you to your balance appointment, we’ll test their hearing free of charge! This way, when you come in for one problem, you help someone you care about potentially identify another issue before it becomes a huge burden.
Contact I Love Hearing now to schedule an appointment for your balance problems. Feeling like you’re spinning or about to fall isn’t pleasant, but at I Love Hearing, we can help you make it livable.