Dr. Gott: Difficulty with balance can have many causes

DEAR DR. GOTT: I’m having trouble with my balance. What can you tell me about the cause?

DEAR READER: Your brief note is very difficult to answer. You don’t give your age, gender, current medical conditions or medications, symptoms, how long you have had this difficulty or any other pertinent information. Therefore, I can only give you very brief, general background on some of the most common causes of balance difficulties.

First, see your primary-care physician. He or she is your best resource for help and will be able to refer you to an appropriate specialist. Be prepared to answer several questions. The doctor will need to know how long you have been experiencing symptoms and which symptoms are causing the balance problems. Are you having abnormal skin or muscle sensations (such as pins and needles) in your feet or legs? Are you having difficulty focusing your eyes? Do you feel as though you are lightheaded, dizzy or faint?

It is important that the physician knows every detail in order to narrow down the list of possible causes. Some of the most common reasons for balance difficulties include vertigo (an inner-ear malfunction), motion sickness, Meniere’s disease, heart abnormalities, low blood pressure, medications, joint damage and anxiety disorders.

Each diagnosis carries its own complications, risk factors, treatment and prognosis. Some, such as the side effects of medications or joint damage, are fairly easily dealt with, while others, such as vertigo and Meniere’s, are notoriously more difficult to treat.

There are several tests that can be used to pinpoint the cause of the problem. Hearing tests, MRIs, CTs, blood work and even specialized eye testing may be used. Because there are several factors (eyes, ears, skin/muscle/nerves) that work together to help us balance, finding the specific cause may take time.

Most balance problems are related to the inner ear and respond to vestibular rehabilitation. This is an exercise program that aids patients in compensating for the loss of balance. Another beneficial step is to take courses for gait abnormalities. This can help sufferers regardless of the cause of their problem. Beyond these steps, treatment is related directly to the cause, so it is vital to be under the care of a physician.

To provide related information, I am sending you copies of my Health Reports “Ear Infections and Disorders” and “Medical Specialists.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a check or money order for $2 per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

DEAR DR. GOTT: I just wanted to write to thank you for saving my life. Quite some time ago, you had an article that stated that if a person suffers from repeated attacks of shingles, the cause may really be a malignancy somewhere in the body.

I had shingles six times and remembered that article. I went to my doctor and told him about it. He then ordered a chest X-ray, and a quarter-sized mass was found. It was caught early, and I am not taking chemotherapy.

DEAR READER: Shingles is a reactivation of the herpes zoster virus (which also causes chickenpox). In people with weakened immune systems (because of cancer or other conditions), the virus can become reactivated many times. In a person with a normal immune system only one outbreak of shingles is likely.

Thank you for the compliment; you deserve three cheers.