Causes of balance and walking problems

Good balance needs many different parts of the body to work together effectively, including:

• the eyes
• part of the inner ear and its connections to the brain
• sensors in joints, muscles and skin

MS might cause problems which in turn cause difficulty balancing:

• Vision – visual problems can give confusing information to the brain when it tries to work out how the body is moving relative to the world around it.


• Sensory changes – changes in sensation, such as numbness or tingling, might mean the brain does not receive the accurate information it needs for proper balance.


• The inner ear – the inner ear constantly updates the brain about the angle and position of the head. If MS damages the message pathways from the inner ear area, confusing or missing signals can add to dizziness and balance problems.


• The ‘cerebellum’ – this part of the brain is particularly associated with the process of balance. If MS causes damage to this area, the brain may be less able to compensate for missing or incorrect messages, or may send out misleading responses to the muscles as the body tries to balance.

Other symptoms

Some symptoms of MS can have a knock-on effect on balance. For example, tremor or muscle spasms or stiffness can mean that the brain processes the information correctly, but the muscle does not respond in the way it was intended. This can have an effect on walking and balance.

Relapses

Your balance and walking might get worse during a relapse. Steroid treatment, either by injection or tablets, can speed up recovery from the symptoms of a relapse.

Infections

Your balance might also be affected if your body temperature rises because of an infection – this is sometimes known as a ‘pseudo-relapse’ because it has the appearance of a relapse but has a different cause.

Infections in the inner ear can upset the body’s balance, often accompanied by vertigo and sometimes vomiting. Drug treatments may help in the early days of an infection like this.

Side effects of drugs

Certain drugs for other symptoms might cause side effects. For example, treatments for muscle spasms and stiffness, and for some sorts of pain, can make people feel dizzy or disorientated.

Medications that relax muscles, such as baclofen or gabapentin, can cause temporary weakness in the muscles which could make walking and balancing more difficult.

Apprehension and anxiety

It is not unusual to feel a sense of apprehension about walking in unfamiliar places when balance is difficult, particularly if it is a new or changing symptom.

Anxiety, in turn, may make balance more difficult, so it is important that the emotional side of symptoms are not ignored.

Find out more about managing anxiety.