Head
Balance problems and unsteadiness
A feeling of being unsteady on your feet, swaying or about to fall — most often from inner-ear conditions affecting the body's balance system, but, when it comes on suddenly with face droop or slurred speech, a possible sign of a stroke that needs emergency care.
Education and reference only. This explains the common causes of balance problems and unsteadiness and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is balance problems and unsteadiness?
Balance relies on a finely tuned partnership between the inner ear, the eyes and the sensation in the feet and joints, all coordinated by the brain. When any part of this system is disturbed, the result is unsteadiness — a sense of swaying, veering or feeling about to fall.
- Get urgent help: Call 999 using the FAST check if loss of balance comes on suddenly with face drooping, arm weakness or slurred speech — this may be a stroke. Call 999 for sudden unsteadiness with a severe headache, double vision, difficulty speaking or swallowing, or numbness on one side.
- Self-care: For unsteadiness that a clinician has confirmed comes from an inner-ear or other non-urgent cause, take sensible steps to prevent falls while it settles: move slowly when standing up or turning, use a handrail on stairs, and remove trip hazards such as loose rugs and trailing cables at home.
About balance problems and unsteadiness
Balance relies on a finely tuned partnership between the inner ear, the eyes and the sensation in the feet and joints, all coordinated by the brain. When any part of this system is disturbed, the result is unsteadiness — a sense of swaying, veering or feeling about to fall. Inner-ear conditions are among the commonest causes: inflammation of the balance nerve, recurrent episodes with a sensation that the room is spinning, or a disorder causing attacks of spinning with hearing change and ringing in the ear. Problems in the brain and nervous system can also affect balance, from the gradual changes of conditions affecting movement to the sudden, dangerous onset that signals a stroke. The crucial distinction is the speed and company of the symptom: balance loss that comes on suddenly with a drooping face, weak arm, slurred speech, double vision or a severe headache is an emergency.
When to get help
Call 999 or go to A&E if balance problems and unsteadiness comes with any of these warning signs:
- Call 999 using the FAST check if loss of balance comes on suddenly with face drooping, arm weakness or slurred speech — this may be a stroke.
- Call 999 for sudden unsteadiness with a severe headache, double vision, difficulty speaking or swallowing, or numbness on one side.
- Seek urgent help for unsteadiness with sudden deafness or severe ringing in one ear.
- Seek urgent help for balance problems after a head injury, especially with vomiting, drowsiness or confusion.
- Seek urgent help if you are falling repeatedly or cannot stand or walk safely.
When to see a doctor
Treat sudden unsteadiness with any stroke sign — face droop, arm weakness, slurred speech, double vision or numbness on one side — as an emergency and call 999. Seek urgent help for balance loss with sudden deafness, a severe headache, or after a head injury. For unsteadiness that comes and goes with inner-ear symptoms, or balance that is gradually worsening and causing falls, book a routine appointment so the cause can be confirmed and balance-retraining or other treatment arranged.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of balance problems and unsteadiness
Balance problems and unsteadiness has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
For unsteadiness that a clinician has confirmed comes from an inner-ear or other non-urgent cause, take sensible steps to prevent falls while it settles: move slowly when standing up or turning, use a handrail on stairs, and remove trip hazards such as loose rugs and trailing cables at home. Good lighting and supportive, well-fitting footwear help. If your balance problem is recurrent, balance-retraining exercises taught by a physiotherapist can be very effective in helping the brain compensate. Stay as active as you safely can, as avoiding all movement tends to make balance worse over time. Avoid driving or operating machinery while you feel unsteady, and rise gradually from lying or sitting to reduce light-headedness.
Answers
Balance problems and unsteadiness: frequently asked questions
How do I know if my balance problem is a stroke?
Use the FAST check: if loss of balance comes on suddenly with a drooping face, a weak arm or slurred speech, call 999 at once. Sudden unsteadiness with a severe headache, double vision or numbness on one side also needs emergency help.
What is the difference between dizziness and a balance problem?
Dizziness usually describes feeling light-headed or that the room is spinning, while a balance problem is the sense of being unsteady on your feet. They often overlap, and many inner-ear conditions cause both at once.
Can inner-ear problems cause unsteadiness?
Yes. The inner ear is central to balance, and conditions such as inflammation of the balance nerve or recurrent vertigo are common causes of unsteadiness, often with spinning sensations and nausea.
Can exercises improve my balance?
Often yes. For many inner-ear and age-related balance problems, balance-retraining exercises taught by a physiotherapist help the brain compensate and reduce unsteadiness and falls. Staying active generally helps more than avoiding movement.
Sources
Where this is drawn from
- NICE CKS: Vertigo.
- Stroke Association: act FAST.
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