Balance Problems

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Diagnosis & Tests

Physical Assessment

If a person has balance problems, their healthcare professional will take a medical history and do a physical exam to diagnose the source of the problem. They will:

  • Evaluate walking to find problems
  • Test balance
  • Ask about previous falls and what was happening before and during the fall.
  • Ask about symptoms, including:
    • when symptoms started and how long each episode lasts
    • severity or strength of symptoms
    • how often symptoms happen
    • vertigo, dizziness, pain, weakness, ringing or fullness in the ears, or problems moving
  • Ask about any prescription and over-the-counter medicines
  • Ask a caregiver or informant what they have noticed

Specialist Evaluation

Your healthcare professional may recommend seeing a specialist depending on the suspected source of the balance problems:

  • For ear problems, an otolaryngologist or ENT (ear/nose/throat specialist)
  • For irregular heartbeats, a cardiologist
  • If there may be nerve damage or brain disease, a neurologist
  • For arthritis, gait (walking) problems, or a need for mobility aids and fall prevention programs, a physical therapist
  • To review medications to minimize problems with balance, a pharmacist
  • To evaluate vision problems, an optometrist or ophthalmologist

Other Tests

You may also have any of the following tests:

  • Dix-Hallpike test. This test checks for dizziness or side-to-side movements of the person’s eyes when they lie on their back with the head hanging slightly off the examination table.
  • Blood pressure tests.  Blood pressure may be measured while lying, sitting, and standing, or when using a tilt table. A person may be asked to wear a 24-hour blood pressure monitor.
  • Blood tests. These tests check for low blood sugar or anemia (low red blood cell counts).
  • Electrocardiogram or echocardiogram. These tests will look for heart abnormalities.
  • The Valsalva maneuver. This involves taking several deep breaths and then blowing out slowly while blood pressure and heart rate are measured. This checks how part of the nervous system is working.

In rare cases, the healthcare professional may order further tests, which are simple and painless. For example, imaging tests, like the magnetic resonance imaging (MRI) or computerized tomography (CT scan).

These tests can help find out if the problem is in the inner ear or there is a different cause.

 

Last Updated January 2023

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