About this symptom
Problems with balance may be described as veering to one side, feeling insecure on stairs, recurrent falls or difficulty turning. Vestibular, neurological, muscle and orthopaedic disorders, as well as some medicines, can contribute.
Clinical features
Gradual unsteadiness differs from a sudden inability to stand or walk. The clinician asks about falls, numbness in the feet, tremor, vertigo, vision and changes in step length or walking speed. One description does not locate the cause reliably.
Important differences and warning signs
The neurological assessment examines gait, coordination, strength, reflexes, sensation and postural stability. Further testing, including specialist vestibular evaluation, depends on the findings and overall history.
Assessment and individual care
Treatment is aimed at the cause. Selected people may benefit from balance exercises, fall-prevention measures and supervised rehabilitation. Difficult exercises should not be attempted alone when the risk of falling is high.
Related information: Dizziness in adults; Muscle weakness.
Signs and symptoms
- Veering, stumbling, unsteadiness on stairs or repeated falls.
- Difficulty turning, altered step length or poor coordination.
- Sometimes accompanied by dizziness, tremor, numbness or muscle weakness.
Diagnosis and tests
The clinician examines gait, balance, coordination, strength, reflexes and sensation before deciding on additional investigations.
Care and treatment approaches
Care may involve targeted rehabilitation and fall prevention as well as treatment of the underlying illness. Safety is essential for people at risk of falling.
When to seek urgent care
Sudden inability to stand or walk, new facial asymmetry, double vision, one-sided weakness or difficulty speaking can indicate stroke. Call 103 immediately.
Frequently asked questions
Does unsteadiness always mean a brain disorder?
No. Inner-ear, peripheral nerve, muscle, joint and medicine-related conditions are among the other possibilities.
What does a neurological examination add?
It helps assess coordination, strength and sensation and guides any further investigations.
When is loss of balance an emergency?
Sudden onset, especially with an inability to walk, weakness or speech changes, calls for emergency help.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
