Maybe you have started grabbing the wall when you walk down the hallway. Maybe you trip more often than you used to, feel unsteady on stairs or notice dizziness when you turn your head. If you are an adult under 60 experiencing balance problems, it can be easy to brush these changes off as stress, fatigue or being out of shape.
However, knowing when to pay attention to these shifts is important. Balance problems can happen at any age. They may be temporary and mild or they may be a sign of something that needs attention.
Many of the things that cause balance problems are treatable. Getting checked early can help you find treatment, prevent falls and stay active.
“If someone is starting to fall down or coming close to falling before the age of 60 in situations they normally wouldn't, this is not something to ignore,” said David Shprecher, DO, a neurologist with Banner Sun Health Research Institute.
What does a balance problem feel like?
Balance problems may feel like:
- Dizziness
- Spinning
- Lightheadedness
- Feeling unsteady
- Tripping a lot
- Veering to one side
- Near falls
Watch for these subtle balance warning signs you may miss:
- Holding the wall more often when you’re walking
- Avoiding stairs or escalators
- Feeling less steady in the shower
- Feeling unsteady when you get out of bed
- Feeling off balance after you turn quickly
- Needing more light to walk safely at night
- Feeling nervous in crowds or open spaces
- Avoiding workouts you used to do
- Feeling like one leg is weaker or less coordinated
- New clumsiness with walking, sports or daily activities
Why balance problems can happen before age 60
Balance depends on your inner ear, vision, nerves, muscles, joints, circulation and brain function. Problems in any of these areas can make you feel unsteady at any age.
You can also have balance issues due to:
- Medications
- Dehydration
- Low blood pressure
- Migraines
- Anxiety
- Poor sleep
- Infections
- Injuries
- Chronic conditions
Common causes of balance problems in adults under 60
A few different issues could cause loss of balance.
Inner ear or vestibular problems
Inner ear problems can cause balance issues, dizziness or vertigo because the inner ear helps control your sense of movement and position. These conditions include:
- Benign paroxysmal positional vertigo (BPPV)
- Vestibular neuritis or labyrinthitis
- Meniere’s disease
Vestibular therapy may help.
Vision changes
Vision helps you orient your body in space, so your balance may feel worse in low light or crowded spaces. Regular eye exams can help identify vision-related causes.
Medication side effects
Some medications can cause balance problems by making you dizzy, sleepy, lightheaded or unsteady. You may notice issues if you take:
- Blood pressure medicines
- Sleep medicines
- Anxiety medicines
- Antidepressants
- Pain medicines
- Muscle relaxers
- Allergy medicines
- Seizure medicines
Alcohol, cannabis and supplements can also affect your balance or interact with medication. Do not stop medication without talking to a provider.
Low blood pressure, dehydration or blood sugar changes
Talk with a provider if you have symptoms like:
- Feeling lightheaded when you stand up, which may be linked to blood pressure changes
- Dizziness and weakness, which could be signs of dehydration
- Shakiness, sweating, weakness, dizziness or confusion, which could stem from low blood sugar
Muscle weakness, joint problems or past injuries
Balance depends on strength and stability in the feet, ankles, knees, hips and core. Past ankle sprains, knee injuries, hip pain, back pain or surgery can affect your balance. And weakness or stiffness may make it even harder for you to walk, climb stairs or manage uneven ground.
Nerve problems
Neuropathy can cause numbness, tingling, burning or reduced sensation and your balance may feel worse in the dark because your body relies more on sensation in your feet then.
Migraine-related dizziness
Some migraines cause dizziness, vertigo or motion sensitivity, even when you don’t have a severe headache. Your symptoms may be triggered by light, sound, stress, certain foods, sleep changes or hormones.
Anxiety and stress
Anxiety can cause dizziness, lightheadedness, muscle tension and feeling unsteady. Plus, balance symptoms can cause anxiety, creating a cycle. Do not assume anxiety is causing your balance problems, especially if your symptoms are new or changing.
Neurologic causes
Less commonly, balance problems can be linked to problems in the brain, spinal cord or nervous system like stroke, multiple sclerosis, Parkinson’s disease, tumors, concussion or other neurologic conditions.
When balance problems need urgent care
Call 911 for any balance problems along with:
- Sudden weakness or numbness on one side
- Face drooping
- Trouble speaking or understanding speech
- Sudden vision loss or double vision
- Sudden severe headache
- Sudden trouble walking or loss of coordination
- Severe unsteadiness
- Fainting
- Chest pain
- Trouble breathing
- Confusion
- New seizure
- Head injury
- Nausea or vomiting
When to see a doctor for balance problems
“Any new tendency to fall before age 60, particularly if it is getting worse, should be evaluated with your primary care doctor,” said Dr. Shprecher.
Schedule a visit for balance problems that:
- Last more than a few days
- Keep coming back
- Cause near falls
- Affect your daily life
- Come with dizziness, numbness, weakness, hearing changes or medication changes
How providers evaluate balance problems
Your provider may:
- Ask when symptoms started and what triggers them
- Ask whether you feel spinning, lightheadedness, weakness or unsteadiness
- Review medications, supplements, alcohol or cannabis use
- Check blood pressure, including when you are sitting and standing
- Check heart rate
- Examine your ears, eyes and nerves
- Test strength, reflexes, sensation and coordination
- Watch how you walk
- Check balance and movement patterns
- Order blood tests, if needed
- Recommend hearing or vestibular testing
- Recommend imaging, if needed
- Refer you to neurology, ENT, cardiology, physical therapy or vestibular therapy (a type of specialized physical therapy for balance issues)
What treatment can help balance problems?
Depending on the cause, balance problem treatment may include:
- Vestibular therapy
- Physical therapy
- Medication review
- Vision care
- Migraine treatment
- Blood pressure or blood sugar management
- Specialist care
“If you are seeing a general neurologist but they cannot figure out why your balance is continuing to worsen, then you should consider consulting a movement disorders specialist,” Dr. Shprecher said. “And even if an illness is not curable, physical therapy can still be helpful.”
What you can do at home while waiting for your appointment
While waiting for care, you can reduce fall risk by:
- Using handrails
- Clearing walkways
- Improving lighting
- Wearing supportive shoes
- Standing slowly
- Avoiding driving if you feel dizzy or unsafe
Do not try balance exercises on your own if you are very dizzy, at high risk of falling or have new neurologic symptoms.
What to track before your visit
Before a balance appointment, track:
- When symptoms happen
- Triggers
- Falls or near falls
- Type of dizziness
- Hearing or vision changes
- Weakness
- Numbness
- Medications
- Recent illness or injury
Bottom line
Balance problems are not just an issue for older adults. If you are under 60 and have balance concerns, it is worth getting checked. Many causes are treatable, especially when they are identified early. A Banner Health provider can help identify what is affecting your balance so you can find the right next step.
Frequently asked questions about balance problems in adults under 60
Is it normal to have balance problems before age 60?
Balance problems can happen before age 60. They should not be ignored if they are new, recurring or affecting daily life.
Why do I feel off balance but not dizzy?
You can feel off balance without spinning dizziness. Causes may include muscle weakness, joint problems, nerve issues, vision changes, medication side effects or neurologic conditions.
Can stress cause balance problems?
Stress and anxiety can cause dizziness, lightheadedness and feeling unsteady. But new or changing balance symptoms should be evaluated before assuming stress is the cause.
Can inner ear problems affect balance?
Yes. The inner ear helps control balance. Inner ear problems can cause dizziness, vertigo, motion sensitivity, nausea and unsteadiness.
When should I worry about balance problems?
Worry about balance problems that are sudden, keep coming back, cause near falls, affect daily life or come with weakness, numbness, speech trouble, vision changes or severe headache.
What doctor should I see for balance problems?
Start with a primary care provider unless symptoms are sudden or severe. Depending on the cause, you may be referred to neurology, a movement disorders specialist, ENT, cardiology, physical therapy or vestibular therapy.
Can physical therapy help balance problems?
Yes. Physical therapy and vestibular therapy can help many people improve strength, stability, coordination and confidence with movement.
Can medication cause balance problems?
Yes. Some medications can cause dizziness, drowsiness, low blood pressure or unsteadiness. Do not stop medication without talking to your provider.
