Why Do I Feel Off-Balance but Not Dizzy? Experts Reveal 7 Common Causes
From weak muscles to vision problems, here’s what can make you feel unsteady
“Dizzy” and “off-balance” may seem interchangeable, but the sensations are unique and don’t always accompany one another. For example, you might feel as though you can’t seem to stand straight without feeling lightheaded. So we asked doctors “why do I feel off-balance but not dizzy?” to get to the bottom of it. Here, they share common causes and underlying medical conditions, plus how to feel steady on your feet again.
Why do I feel off-balance but not dizzy? 7 causes
Many potential factors can cause you to feel physically unsteady, but not necessarily woozy. Experts say these are some of the most likely reasons you feel off-balance but not dizzy.
Decreased muscle mass
Loss of strength in muscles around the hips, knees or ankles can impair balance, explains Joseph R. Hribick, DPT, Certified Orthopedic Manual Therapist and Clinical Assistant Professor of Physical Therapy at Lebanon Valley College.
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“Normally, strong leg muscles help to quickly correct minor losses of balance,” says Hribick. “When there is a loss of strength in these muscles, reaction time may be slower and increase the risk of falls. Loss of muscle strength in the legs can also affect one’s ability to climb stairs and get up from a chair and lead to the feeling of being off-balance.”
Muscle mass and strength naturally decline with age, especially in the lower body, he notes. But a loss in muscle strength may also occur following surgeries, hospital stays and prolonged periods of inactivity.
Low blood pressure
A sudden drop in blood pressure (postural hypotension) occurs when standing up after sitting or lying down due to delayed blood flow to the brain, explains Hribick. When you stand up, gravity pulls blood toward your legs. If your body doesn’t adjust quickly, less blood reaches the brain and can make you feel off-balance but not necessarily dizzy. If you take blood pressure medication, you may be more susceptible to this phenomenon.
Vision problems
“Vision plays a critical role in maintaining balance by providing the brain with essential information such as our body’s position, movements, spatial orientation and depth perception,” says Hribick.
Aging eyes and certain ocular conditions can impair these capabilities, which can lead to feeling off-balance, he explains. Reduced depth perception can lead to difficulty judging distances and cause missteps, and limited contrast sensitivity makes it harder to see obstacles and can increase the risk of feeling off-balance and falling.
What’s more, poor peripheral vision results in difficulty seeing obstacles to the side which can lead to feeling off-balance. And issues with night vision make it difficult to feel balanced in dimly-lit areas, adds Hribick.
Joint conditions
Degenerative joint conditions such as arthritis are associated with pain and joint stiffness, often leading to limited range of motion, says Hribick.
“This is especially problematic when joints such as the knees and ankles are affected, as it makes it harder to take normal steps and recover from an unexpected loss of balance,” he adds.
Peripheral neuropathy
Damage to the sensory nerves outside of the brain and spinal cord such as in the legs and feet occurs with peripheral neuropathy. These nerves help detect pressure, touch and position in our feet and legs. When they’re compromised, the brain doesn’t receive accurate feedback from the feet and has difficulty determining body position, making it harder to adjust posture and maintain balance, explains Hribick.
Causes of peripheral neuropathy include diabetes, blood flow issues, vitamin deficiencies, thyroid issues and side effects from certain medications, he notes.
Decreased body awareness
Proprioception describes your body’s capacity to recognize its positioning within its surroundings, explains Gbolahan Okubadejo, MD, FAAOS, NYC-based Spinal and Orthopedic Surgeon.
“The ability to sense your body position can diminish from injuries or aging and from living a sedentary lifestyle,” says Dr. Okubadejo.
Inner ear issues
Your vestibular system controls your sense of balance. Vestibular hypofunction is inner ear weakness that can make you feel dizzy, but can also present balance difficulties without producing vertigo symptoms, Dr. Okubadejo explains.
When to see your doctor if you feel off-balance
While some of these causes can be easily managed, you should still see your doctor if you experience balance problems to rule out more serious underlying health conditions.
“Consult a doctor when your balance issues continue to persist or increase in severity or if they disrupt your everyday routine,” advises Dr. Okubadejo. “The occurrence of repeated falls, along with unexpected weakness and coordination problems, may signal the presence of a neurological disorder, including peripheral neuropathy or early stages of diseases like multiple sclerosis or Parkinson’s disease.”
Medical attention becomes essential when imbalance comes with vision changes or trouble walking combined with recent head trauma, or when mild symptoms persist for weeks despite home remedies, he adds.
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