Can Hearing Loss Affect Your Balance?

Middle-aged couple balancing one leg while having fun on the foreshore of a coastal town

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Can hearing loss affect your balance? For many individuals diagnosed with some degree of hearing loss, this question brings forth worries about their mobility going forward. Indeed, hearing loss can negatively influence balance, but the good news is that it won’t be enough to stop you from leading a full and enjoyable life.

Studies have found that those with mild hearing impairment are three times more likely to have reported falling within the past year compared to individuals with normal hearing.

However, by arming yourself with knowledge about how healthy hearing contributes to maintaining your stability, you’ll be well on your way to building confidence as you navigate life’s adventures. With supportive guidance from friends and family – or even professionally certified audiologists – you’re well-equipped with what you need to make every experience unique and enjoyable!

Your body’s hearing and balance systems are connected and often work together to keep you steady. When soundwaves enter your ears, they vibrate tiny hairs, sending messages to the brain about the speed and direction of motion. The messages help your brain understand where it is in space to maintain balance and coordination.

Balance problems can affect people of all ages; however, they can become more typical with age. Age contributes to balance issues in various ways, such as brain or body structure changes, certain medications and hearing loss. Age-related hearing loss can significantly impact balance because as our hearing diminishes, we can no longer rely on sound cues to help us maintain balance.

Read on to discover more about the connection between hearing and balance and how to manage the risks associated with hearing impairments.

The Relationship Between Hearing and Balance

Your hearing system provides spatial awareness and allows you to move while avoiding obstacles. The ears receive sound and input it to the brain to understand the surrounding environment. The sensory information ears collect and send helps us to understand our orientation and balance.

Every day, our brains use auditory data provided by the ears to maintain steady bodily balance. Our ears are vital for body stabilisation and coordinated movement, such as driving a car or navigating a crowded room. Without these inputs from the ears, maintaining physical balance would be an immense challenge!

The inner ear helps us to maintain our balance. The inner ear has two parts: the vestibular system, which senses movement and orientation of the head relative to gravity, and the cochlea, which is responsible for hearing.

The vestibular system works with other systems in the body, such as vision, proprioception (our sense of where our limbs are in relation to each other) and sounds through information gathered by both ears. When we have a hearing impairment, some of this information cannot be adequately processed, leading to problems with balance and coordination.

How Do We Stay Upright?

Everyday activities like sitting, standing, and walking may seem effortless at first glance. However, to truly appreciate the complexity of our natural balance system, you need only look within our inner ear labyrinth, where three distinct parts interact seamlessly to keep us upright:

  1. The semicircular canals, which detect body motion;
  2. The otolithic organs, which detect head inclination;
  3. And the cochlea, which processes sound.

With this delicate interplay between these essential components, we can perform basic motor functions and stay upright.

Semicircular Canals

The semicircular canals are a collection of three individual ‘loops’ that detect our body movements and provide sensory feedback based on the direction and speed of the input change. This information is then sent to the brain via several nerve pathways, making us aware of whether we are moving forward, backward, or tilted from side to side. In this way, the semicircular canals alert us to body motion and help keep us balanced and steady, whether in a standing position or as we move about our daily activities.

Otolithic Organs

The otolithic organs, composed of the utricle and saccule, are located in the inner ear and provide important information about the direction and speed of head movement.

Primarily comprised of calcium carbonate crystals, these sensory organs act as a gravitometer measuring changes in gravity related to head orientation, tilt and translation.

These organs also play a role in maintaining balance during physical activity. As such, they are integral to helping us recognise our equilibrium, facilitating postural adjustments accordingly.

Understanding how these organs contribute to our sense of motion and balance can be vital in understanding conditions where their disruption can result in imbalance or vertigo.

Cochlea

The cochlea, found in the inner ear, is responsible for processing sound. It can provide valuable information about our environment and is essential to maintaining balance. Sound can also help us keep track of our position in space and alert us to potential obstacles or hazards.

How Can Hearing Loss Affect Your Balance?

People with hearing loss often struggle with balance and are at a higher risk of falling. There are three prominent hypotheses as to why they may experience difficulty with staying balanced.

First, they may not be aware of the people, animals, obstacles or potential dangers surrounding them due to decreased environmental awareness.

Secondly, their spatial awareness is impaired, making it harder for them to correctly gauge the location of their body in relation to objects around them.

Lastly, since the brain is using more resources for hearing and interpreting speech and sound rather than focusing on balance or gait, it may increase the likelihood of falling.

Hearing health should be a priority for anyone concerned about balance and well-being. Without a clear indication of where sounds are coming from and how far away they are, individuals with hearing loss may become oblivious to their surrounding environment, which naturally increases the risk of slips or falls. 

Does Hearing Loss Increase the Risk of Falls?

Research has found that people with hearing loss are more likely to experience falls than those with normal hearing, creating an increased need for safety measures. People with even the slightest hearing loss are three times more likely to have an accidental fall. And for every extra 10 decibels of hearing loss, the probability increases by an incredible 140%.

Anyone caring for someone who is living with a hearing impairment should take extra measures to ensure their safety, including paying attention to uneven surfaces and providing assistive devices for mobility or communication when necessary.

Conditions That Affect Hearing and Balance

Aging

As people age, the effects of time on their physical and mental abilities become more noticeable. Generally, hearing, cognition, and balance abilities decline over time due to the normal aging process.

The body can naturally produce less fluid in the inner ear as we age, leading to an increased risk of dizziness and imbalance. Additionally, age can lead to various health conditions such as high blood pressure, diabetes or neurological diseases that can further impact balance and coordination.

Ménière’s Disease

Ménière’s Disease is a condition that affects the inner ear and causes episodes of vertigo, hearing loss, tinnitus, and a feeling of fullness in the ear. It has been linked to abnormal fluid pressure within the inner canals of the ear.

The precise cause of this condition is unknown. Theories suggest that viruses, allergies or autoimmune reactions might be responsible for its development. Some evidence also indicates that Ménière’s Disease might be related to genetic factors or environmental triggers.

Labyrinthitis

Labyrinthitis is an inner ear disorder that can cause various symptoms such as vertigo, headaches, ringing in the ears and hearing loss. It occurs when your inner ear is inflamed, which can be caused by an infection or injury. These infections are usually viral but can occasionally be bacterial.

Furthermore, this condition may also be caused by an autoimmune response directed towards the organ in the inner ear responsible for balance, known as the labyrinth.

In addition, some medical treatments like chemotherapy or antibiotics may also be a contributing factor to Labyrinthitis.

Despite its painful symptoms, most people fully recover within several weeks to months after diagnosis.

Vestibular Neuronitis

Vestibular neuronitis is an inner ear disorder that causes severe balance and related issues due to inflammation of the vestibular nerve. It appears to be caused by a viral infection, as it typically follows a cold or period of illness and involves no bacterial infection. However, the exact cause of vestibular neuronitis is uncertain, with one individual able to have more than one underlying cause.

In either case, symptoms generally include dizziness, a spinning sensation known as vertigo, nausea, loss of balance and difficulty coordinating eye movements or focusing on objects in motion. Luckily, most people who experience this condition recover within 3-4 weeks without long-term consequences.

Benign Paroxysmal Positional Vertigo (BPPV)

Positional vertigo, or benign paroxysmal positional vertigo (BPPV), is characterised by spatial disorientation and dizziness triggered by specific head movements. Disruption of our inner ear’s balance can cause an unsettling condition known as BPPV. This disruption produces unexpected signals in the brain, leading to a feeling that one is out-of-sync with their environment.

Often this occurs when tiny calcium crystals become loose in the canals of the inner ear. Still, it can also stem from an injury to the head within the last 24 hours or a movement disorder such as repetitive exercise or weightlifting. It may also be caused indirectly by an infection in the ear, which causes inflammation that damages the inner ear’s delicate fluid balance system.

Mal de Debarquement Syndrome (MdDS)

Mal de Debarquement Syndrome (MdDS) is a rare disorder affecting the balance control system of the body. MdDS causes feelings of rocking, swaying, unsteadiness, or bobbing, even though the person is standing still. The intensity of the symptoms can vary from patient to patient but typically last for months or even years.

Prolonged exposure to motion can cause MdDS, such as being on a ship for long periods or riding in a car for extended journeys. However, it can also appear after other kinds of sustained movement exposures.

Unfortunately, there is no definitive diagnosis or cure, although various management strategies may temporarily relieve symptoms.

Perilymph Fistula

Perilymph fistula is a rare medical condition caused by trauma to the ear. It involves a disruption in the inner and middle ear seal that usually keeps fluid in place. This disruption results from fluid leaking out of the inner ear into either or both ear canals. The misplaced fluid causes symptoms such as vertigo, tinnitus, hearing disturbances, and difficulties with balance.

Perilymph fistula can be diagnostically complex. Treatment typically involves a combination of medications and specialised physical therapy to help reduce symptoms and repair any structural problems in cases with identifiable sources of damage.

Managing Hearing and Balance Issues

It is vital for those with hearing impairments to take extra care when walking or navigating their environment. Simple strategies like avoiding hazards such as slippery surfaces can reduce the chances of falling or tripping.

Hearing loss can affect balance, but there are ways to manage it appropriately. Wearing corrective hearing devices can improve sound localisation and situational awareness, while regular exercise can help strengthen the vestibular system.

Regular physical activity helps to strengthen the vestibular system, a part of our inner ear responsible for helping us maintain equilibrium and mobility. The good news is that any type of movement can be beneficial; walking, running, swimming or low-impact exercises such as yoga or Tai Chi.

Hearing aids can help those with hearing impairments to maintain their balance by providing improved sound localisation and situational awareness. Hearing aids can also reduce confusion and disorientation in noisy environments. Additionally, sound amplification can help those with hearing loss detect potential hazards, such as approaching cars when crossing the street.

Wearing a medical alert device can help you call for help immediately if an incident occurs due to impaired vision or mobility. A doctor might suggest footwear to reduce the risk of trips and falls. There are also assistive devices that can help with balance.

How an Audiologist Can Help

Audiologists can diagnose hearing and balance problems through a comprehensive ear exam to assess the functioning of both inner-ear components. They can also perform tests such as pure tone audiometry, tympanometry, and otoacoustic emissions to measure response to sound and evaluate the results against age-related norms to determine any issues.

An audiologist may sometimes refer a patient to an Otolaryngologist or Ear, Nose & Throat (ENT) specialist for further evaluation or treatment. An ENT doctor can perform specialised balance tests to identify neurological issues or other physical abnormalities that affect balance. These tests can consist of testing eye movements and coordination when standing on different surfaces or walking at various speeds and can help identify the cause of any balance issues.

Finding What Works Best for You

A range of medical conditions can affect hearing and balance, but there are many ways to manage these issues. Wearing corrective hearing aids can help improve sound localisation and situational awareness for those with hearing impairments, while regular exercise can strengthen the vestibular system.

An audiologist can diagnose any underlying problems through comprehensive ear exams, whilst an ENT specialist may be able to identify neurological or physical abnormalities that affect balance. With the proper knowledge and strategies, people can still live full lives despite their hearing loss or balance difficulties – it’s just about finding what works best for you!

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