Why Do I Keep Losing My Balance?
Balance problems that keep coming back often have more than one cause. Inner-ear conditions, changes in eyesight and muscle weakness all play a part. But one factor is often missed: whole-body alignment. When your skeleton is not stacked well from feet to head, your centre of mass shifts. Your muscles then work harder to keep you upright, and you feel unsteady on your feet, especially when walking.
Key points
- Balance depends on three systems working together: your inner ear, your eyesight and the position sensors in your joints and muscles (proprioception).
- Skeletal alignment is a fourth piece of the puzzle, and it is often missed. A shifted centre of mass makes every step less stable.
- Scans done lying down cannot show how your alignment behaves under gravity and body weight.
- A standing whole-body image shows the full chain, from your feet to your head, so the real cause of unsteadiness can be found.
- Sudden dizziness, numbness or weakness needs urgent medical attention, not an imaging appointment.
When to get urgent help
If your loss of balance comes with sudden dizziness, vertigo, slurred speech, numbness, weakness in an arm or leg, loss of bladder or bowel control, or a severe headache, please contact your doctor or go to the nearest emergency department straight away. These symptoms may point to a neurological or vestibular cause that needs immediate medical attention, not a scan booking.
What does feeling off balance look like in daily life?
It is not always dramatic. Many people describe a vague unsteadiness rather than a full stumble. You might notice it most in certain situations.
Feeling as if you drift to one side, or needing to touch a wall when you turn a corner.
Legs that tire quickly when you stand still, such as in a queue or at a kitchen counter.
Avoiding stairs, escalators or uneven ground because you do not trust your footing.
Struggling to stand on one leg, such as when putting on socks or stepping into trousers.
What causes balance problems in adults?
Balance relies on three sensory systems sending the brain matching information. When one or more falls out of step, you feel unsteady.
Conditions such as BPPV or vestibular neuritis disturb your sense of where you are in space.
New glasses, cataracts or reduced side vision change the visual cues your brain relies on.
The sensors in your joints and muscles become less accurate with age, arthritis or neuropathy.
Sarcopenia (age-related muscle loss) weakens the legs and core that hold you steady.
These causes are well known. What is talked about less often is the structural side: how the position and alignment of your skeleton affect where your centre of mass sits, and how much work your muscles must do to keep you upright.
How does whole-body alignment affect your balance?
Your body is a connected chain. Your feet support your knees, your knees support your hips, your hips support your spine, and your spine supports your head. When one link shifts, the rest must make up for it.
If your spine curves forward more than it should, a pattern sometimes called forward leaning posture, your centre of mass moves ahead of your base of support. Your muscles must fire harder and faster to stop you tipping over. Over time, this increases postural sway, which is the small back-and-forth movement your body makes while standing still. More sway means less stability.
The medical term for how well your spine is balanced over your pelvis and legs is sagittal balance. Research shows that when sagittal balance is poor, the risk of falls rises, particularly in older adults. The problem is that standard imaging done lying down does not capture this. When you lie on a scanning table, gravity is removed and your muscles relax. The alignment picture can then look very different from what actually happens when you are on your feet.
How is balance-related alignment checked standing up?
A standing whole-body EOS scan captures your skeleton from head to feet while you carry your full weight. This matters for balance problems because it shows where your centre of mass sits compared with your base of support, exactly as it is when you walk or stand in everyday life.
EOS uses about 90% less radiation than a standard X-ray, around ten times less. The scan takes seconds and you simply stand still inside the machine. The image lets a specialist measure how well each part of your body stacks above the one below it, and spot the ways your body has compensated.
Wondering whether a standing alignment assessment could explain your unsteadiness? Learn more about sagittal balance or talk to us directly.
Book a free video consultationWhen MRI is the better tool: EOS shows bones, joints and alignment. If your balance problems could involve soft tissue, nerves, discs or an inner-ear condition, MRI or other specialist tests are usually more suitable. Your doctor or consultant can advise which you need.
What can you do about balance problems?
Improving balance usually involves a mix of approaches. Having the right information is the starting point.
- Targeted exercises. Strength and balance training, such as practising standing on one leg, heel-to-toe walking and gentle resistance work, can reduce the risk of falls. A physiotherapist can tailor a programme to your needs.
- Eye and vestibular checks. An up-to-date eye test and, if needed, a vestibular assessment can rule out or address sensory causes.
- Understanding your alignment. If exercises and medical checks have not fully solved the problem, a whole-body standing scan can show whether structural alignment is part of the picture. This information can then guide a physiotherapist, osteopath or surgeon in planning the right approach.
ScanAlign is a diagnostic imaging clinic. We do not provide treatment. What we do is give you and your treating specialist the standing alignment data that imaging done lying down misses. ScanAlign standing EOS imaging shows the full picture so decisions about your care are better informed.
Before you start a treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
Frequently asked questions about balance problems
Walking needs a constant shift of your centre of mass from one foot to the other. If your overall alignment is shifted, your muscles must work harder to control each step. This can make you feel unsteady, especially on uneven ground or when you are tired.
Some loss of balance is common with age, due to less muscle mass, slower reflexes and changes in proprioception. However, frequent unsteadiness is not something you simply have to accept. Finding the factors that contribute, including alignment, can help you address them.
Yes. When your posture shifts your centre of mass forward or to one side, your body compensates with extra muscle effort and changed movement patterns. Over time, this reduces your stability and increases postural sway.
It is an EOS scan that images your whole skeleton from head to feet while you stand upright and carry your weight. This captures how gravity and your muscles affect alignment, something scans done lying down cannot show.
EOS uses about 90% less radiation than a standard X-ray, around ten times less. It is very low dose and the scan itself takes only seconds.
No. ScanAlign is a private self-pay service. You can book directly yourself and start with a free video consultation to discuss whether a standing scan is suitable for you.
The price for patients travelling from abroad is confirmed during the free video consultation. You can visit our booking page or book a free video consultation to find out more before you commit.
Dizziness usually involves a spinning feeling (vertigo) or light-headedness and is usually related to your inner ear or blood pressure. A balance problem is feeling physically unsteady on your feet, which can be structural, muscular or neurological. The two can overlap, so see your doctor if you are unsure.
Yes. Evidence-based balance and strength exercises, such as those in programmes recommended by the NHS Falls Prevention service in the UK, can significantly reduce the risk of falls. A physiotherapist can design one for you. If alignment is also a factor, imaging data helps them target the programme more effectively.
ScanAlign is at 19 Harley Street, London, inside The Harley Street Hospital. You can book a standing posture scan after a free video consultation, where you can discuss your needs first.
Could alignment be part of your balance problem?
A free video consultation is the easiest way to find out whether a standing whole-body scan is right for you, before you plan a trip to London. No referral needed, no pressure.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- Glassman SD, Bridwell K, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30(18):2024-2029.
- NHS. Falls: prevention in older people. Clinical Knowledge Summaries. NICE CKS.
- Peterka RJ. Sensory integration for human balance control. Journal of Neurophysiology. 2002;88(3):1097-1118.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.