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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35042
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I CAN'T KEEP MY BALANCE WHEN WALKING. COULD EAR BE PROBLEM.

Customer Question

I CAN'T KEEP MY BALANCE WHEN WALKING. COULD EAR BE PROBLEM. I JUST HATE NOT BEING TO WALK. I USE A CANE AND AM 83, BUT UNTIL 2 OR 3 YEARS AGO I DIDN'T HAVE THIS PROBLEM. MARCIA BURWELL
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Anil replied 2 years ago.
Hello,
Most balance problems are due to inner ear problems.
BPPV is the most common.In BPPV, small calcium particles in the inner ear become displaced and disrupt the inner ear balance sensors, causing symptoms.
Probably in your case this has already been ruled out.
Infection of middle ear can cause balance problems.
Ménière's Disease can cause balance problems.
So Yes ear can be a problem.
Expert:  Dr. Anil replied 2 years ago.
If you have any further query then we can discuss it thoroughly rather than give us poor/bad service.
We are here to help you until you satisfy.
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Thanks.
Expert:  Dr. Arun Phophalia replied 2 years ago.
I disagree with the above expert. The cause in your age group is not likely to be ear. With investigations ruling it out; the chance further decreases. Walking imbalance is usually combination of;
a) Muscle issues
b) Joint issues like arthritis
c) Neurological (neuropathy, inadequate cerebellar control etc)
d) Medications (if you are on any).
Following are the possible causes of balance and incoordination problem during walking (a combination of all below issues);
1) Sitting balance and arising from chair problem; proximal muscle weakness, arthritis, or neurologic disease are the causes. Treatment is muscle-strengthening exercises, and treatment of specific conditions, such as arthritis.
2) Neck turning and extension; Neck arthritis (cervical arthritis, cervical spondylosis), or vertebral-basilar insufficiency can cause this. Treatment options include avoidance of quick head-turning and physical therapy.
3) Standing balance; causes are orthostatic hypotension, cerebellar disease, sensory deficits, muscle weakness, or pain. Treatments are muscle strengthening, using an assistive device, improved foot care, medication adjustment, and treatment of specific diseases.
4) Unstable turning around; causes to consider are cerebellar disease, hemiparesis (stroke), visual field cut, or reduced proprioception (sensation). Treatment possibilities are assistive devices, proper shoes and gait training.
5) Unsafe sitting down; may have proximal muscle weakness or poor vision. Treatment options include muscle strengthening, raising the height of the seat, and visual assessment.
You would need a neurological assessment and following investigations;
a) Muscle charting for the muscle strength
b) MRI of the brain and spine (you may repeat them if already done)
c) Electromyography
d) Blood work like CK which is a muscle enzyme.
Treatment had been discussed above and is dependent on the diagnosis. Mainstay of the treatment is physical therapy.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
Thanks for using Just Answer.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Please let me know if you have further queries or unanswered questions.
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Thank you.
Wishing you all the very best in life.