Treatments for balance problems
There are things you can do to improve your balance.
Some of these you can do on your own. For others, you'll need support from a professional such as an MS nurse, physiotherapist or occupational therapist.
Exercises for balance and walking
We worked with physiotherapist Ruth to create some simple exercises to help you manage you balance and walking. You can do the exercises at home without any special clothes or equipment.
Watch the film to see Tracey give the exercises a go, and try them for yourself too. There is an audio described verison of this video.
Other treatment options
A well-designed physiotherapy programme can help improve balance. There are different types of exercise that may be useful, including exercises specifically designed to improve balance.
The programme could also include exercises that focus on posture, and the strength and suppleness of your muscles, which could in turn benefit your balance.
There's evidence to suggest that a range of exercise therapies, including yoga, Pilates, T'ai Chi, the Feldenkrais Method and the Alexander Technique, along wtih aerobics and outdoor walking, can also help.
Aids, equipment and adaptations
Getting out and about
There are things you can do if balance issues have affected your ability to get out and about safely.
You may ﬁnd you need to pay more attention than usual to balancing when you walk and move around. You may ﬁnd it easier if you focus on walking, without doing anything else at the same time (such as talking).
Using a stick or other walking aid at times can also help. Some people ﬁnd it particularly helpful in open spaces, or in unfamiliar places. Your occupational therapist and the Disabled Living Foundation can give you further details about equipment available.
At home - simple adjustments, or perhaps some adaptations, may help if you ﬁnd it difﬁcult to move around your house safely. An occupational therapist can also help you ﬁnd suitable adjustments or adaptations.
At work - There may also be useful changes that can be made in your workplace. Employers have a legal duty to make reasonable adjustments to help you do your job.
Splints and Functional Electrical Stimulation (FES)
If you have problems with dropped foot (meaning you can’t lift your foot up properly when you’re walking) you may benefit from a splint or Functional Electrical Stimulation (FES).
Functional Electrical Stimulation (FES) is a piece of medical kit that helps people who have ‘dropped foot’ (also called ‘foot drop’). This is when you can’t lift your foot properly when you walk. It can happen when MS has caused damage in the part of your brain or spinal cord that controls how your leg works. It also happens when MS had made a leg muscle weak or too tight. When you have dropped foot, you’re more likely to trip or fall over.
The FES machine is about the size of a pack of cards and is run by a battery. You can wear it on your belt, in your pocket or on a strap wrapped around your knee. Two wires go from it and end in patches that have electrodes in them. These stick to the lower part of your leg, beneath your knee, where the nerve is that controls your muscle.
As you walk these electrodes are triggered to send signals to your leg muscle. This makes it tighten for a second or two, helping you lift your foot better. This signal doesn’t hurt but you’ll get a ‘pins and needles’ feeling when the signal is triggered. Some types of FES devices don’t have wires. You wear them around your shin and the electrical signal is triggered by movement when you walk.
FES helps you walk faster, easier and with more confidence. If you want to try it, ask your MS nurse, GP, or neurologist. They can refer you on to your local FES service if there is one. There they’ll assess you to see if FES is right for you.
The NHS where you live decides if they’ll pay for you to have FES and in some places it can be hard to get. You can pay to have it privately but this costs between £3,000 and £5,000.
Fampridine, also known as Fampyra (and in America as Ampyra), is a drug that can help with walking. It helps about one in three people who take it. If this drug works for you it can speed up your walking by about 25%. This improvement can get less the longer you take the drug but walking is still better than if you'd never taken it. You take this drug as a tablet twice a day.
Can I have this drug?
Fampridine has been available in Europe since 2011, but access to it on the NHS varies across the UK.
- In England, NICE (National Institute for Health and Care Excellence) recommends which drugs are available on the NHS. In 2014 they decided this drug isn't cost effective. In other words, they didn't feel it gives people enough improvement in their symptoms for how much it would cost the health service.
- In Northern Ireland, the Department of Health also applied this decision by NICE.
- In Wales in 2019, the All Wales Medicines Strategy Group did recommend fampridine for use on the NHS.
- In Scotland in 2020, the Scottish Medicines Consortium (SMC) approved it for use on the NHS.
Adults with MS in Scotland and Wales qualify for it if they have difficulty walking and score between 4 and 7 on the Expanded Disability Status Scale (EDSS).
We’re working to get this drug made available on the NHS to all people who could benefit from it - no matter where in the UK they live.
If your GP, MS nurse or neurologist think you need this drug they can ask the NHS locally to pay for it but this isn't usually successful. The drug is available privately for people who can afford to pay for it (from £2,500 a year, at least).
We believe if you have MS, you should get access to the right treatments at the right time, no matter where you live or what your financial situation is. We'll carry on campaigning to make fampridine available on the NHS across the UK.