Feeling Unsteady: A Guide to Better Balance

This article was researched and documented by Michael B, PT.

Falls have been the most common accident that warrants an emergency room visit.

In recent statistics, one in three adults 65 and older has had a fall at least once. Most of the time, patients will complain of feeling unsteady or wobbly. Balance, as defined, is the ability to distribute weight evenly to enable someone to hold a steady position or move at will without falling.

To keep our body balance, several systems interplay to keep us stable. The Central Nervous System, or CNS (brain and spinal cord), the Vestibular System (brain and inner ear) and the Visual System (brain and ear) all play an interactive role. Aside from these systems, our body utilizes sensors that help keep us from falling. Proprioceptive sensors are small sensors that can be found around joints, muscles and tendons. They give feedback to the CNS to keep us stable. When one or two of these systems are impaired, then we have instability. Statistics show that:

  • Four out of five fall deaths in one year are people 65 and older.
  • Men are more likely to die from falls, while women are more likely to be injured.
  • Almost 90% of hip fractures are a result from a fall.

Health conditions that affect balance include:

  • Vestibular disorders
  • Eye disorders
  • Arthritis
    Peripheral Neuropathy
  • Heart Arrhythmia
  • Stroke
  • Parkinson’s Disease
  • Multiple Sclerosis

Medications affect balance, too.

Medications also affect balance. More often, it is due to the amount of medicines taken rather than from a single drug. Taking several drugs at the same time increases the risk of developing side effects. Older individuals are more predisposed because drugs are absorbed and broken down differently as people age. Drugs that increase fall risk are antidepressant, anti-anxiety, antihistamine, antispasmodic, blood pressure and heart drugs, opioids/NSAIDs and sleep drugs.

Fall Prevention

Falls are a fact of life especially for the elderly. Falls happen when a person develops a health condition or takes medications that affect balance coupled with an extrinsic risk factor such as a broken pavement, clutter, ice or a wet floor. Strategies to reduce fall risk would be to alleviate medical conditions (vision), check prescription medicine intake, and reduce extrinsic risk factors such as installing grab bars or remove clutter. However, the most promising strategy is exercise or physical therapy. A fall and balance evaluation by a physical therapist helps reduce fall risk by 13%.


Harvard Medical School. Better Balance: The Harvard Medical School Guide to Enhance Stability and Preventing Falls. Boston, MA. Harvard Health Publications.

How Outreach Can Help

We provide in-home Physical Therapy, Occupational Therapy, and Speech Therapy to individuals that have a difficult time getting/going to an out-patient rehabilitation facility on a consistent basis, prefer not to go to a facility, or those that are more effectively treated within their home.

We also have an out-patient clinic at 1110 2nd Avenue in the Sutton Place/UES area where we provide therapy for those who are adamant about receiving care in a clinic setting. Our evaluations are 45 minutes and treatments are one-to-one with an ample amount of treatment time per client (no double bookings allowed.)