Treatments for balance problems

Falls, dizziness and balance problems are common MS symptoms. But there are things you can try to manage them and improve your mobility.

Finding the cause of balance problems helps find the right way to treat them. For example, vertigo (a spinning sensation) can be caused by an infection or something called ‘benign paroxysmal positional vertigo (BPPV)’. These can have different treatments than if it was caused by your MS.

Lots of things can affect balance, there might be several things that help. It’s important that the cause is investigated.

What can help you walk better with MS?

Exercises for balance and to improve walking
Physiotherapy
Aids, equipment and adaptations
Orthotics (splints and braces) and FES for foot drop
Fampridine (Fampyra) – a drug treatment

Some of the things that might help you manage balance problems are things you can do on your own. For others, you'll need support from a professional such as an MS nurse, physiotherapist or occupational therapist. They might advise you to have a balance assessment.

Physiotherapy for balance

A well-designed physiotherapy programme can help improve balance. There are different types of exercise that can help, including ones specifically designed to improve balance.

Physiotherapists can help with assessments, balance retraining and advice around preventing falls. They can also advise you on whether functional electrical stimulation (FES) or an exercise programme could help if you have foot drop.

A physiotherapy programme could 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 with aerobics and outdoor walking, can also help.

In some cases, exercise in water might help. For example, hydrotherapy or aqua aerobics. The water provides extra resistance and can reduce the rise in body temperature that comes with exercise but which may worsen fatigue

There’s some evidence that exercises at home using computer games with hand-held controllers like a Nintendo Switch or Wii can work well. They can help make exercising fun.

Our physical activity specialist can help you find ways to stay active. They’re part of our MS Help Hub.

Find out more about physiotherapy

Aids, equipment and adaptations

Getting out and about

There are things you can do if balance issues affect how get out and about safely.

Some people find it helps to focus only 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, on uneven surfaces, or in unfamiliar places. An occupational therapist and the Living Made Easy website can give you more details about equipment that’s available.

Adaptations

At home – simple adjustments, or perhaps some adaptations, might help if you ﬁnd it difﬁcult to move around your house safely. An occupational therapist can help you ﬁnd things that work for you.

At work – There could be useful changes that can happen in your workplace. Employers have a legal duty to make reasonable adjustments to help you do your job.

An occupational therapist can help assess your home and workplace and advise on ways to make balance easier. For example, they might suggest aids and equipment that could help, or adaptations (large or small) to help.

Read about how an occupational therapist can help with MS

Treatments for vertigo

Vertigo is a fairly common MS symptom, but there are other causes too. So it’s important to get a health professional to assess your symptoms before discussing treatments with you.

Treatment for vertigo could include physiotherapy – for example, by seeing if certain head positions make your vertigo worse. Then working with you to build up a tolerance so the vertigo lessens even when your head is in that position.

Drug treatments can sometimes help with vertigo and could include:

Antihistamines
Anti-nausea drugs including betahistine and cinnarizine, dimenhydrinate (Arlevert)
Steroids

Treating and managing foot drop

Foot drop, or dropped foot, is quite a common MS symptom and can make it hard to keep your balance. Foot drop is when you find it hard to lift the front of your foot properly as you walk. Treatments for foot drop include physiotherapy, ankle supports (orthotics) or FES (functional electrical stimulation).