Why Do I Keep Losing My Balance?
Repeated balance problems often have more than one cause. Inner-ear conditions, vision changes and muscle weakness all play a role. But one overlooked factor is whole-body alignment. When your skeleton is not stacked well from feet to head, your centre of mass shifts, your muscles work harder to keep you upright, and you feel unsteady on your feet, especially when walking.
Key takeaways
- Balance depends on three systems working together: your inner ear, your vision and the position sensors in your joints and muscles (proprioception).
- Skeletal alignment is a fourth, often missed, piece of the puzzle. A shifted centre of mass makes every step less stable.
- Lying-down scans cannot show how your alignment behaves under gravity and body weight.
- A standing whole-body image reveals the full chain, from your feet to your head, so the real cause of unsteadiness can be identified.
- Sudden dizziness, numbness or weakness needs urgent medical attention, not an imaging appointment.
When to seek urgent help
If your balance loss comes with sudden dizziness, vertigo, slurred speech, numbness, weakness in a limb, loss of bladder or bowel control, or a severe headache, please contact your GP, call 111, or go to A&E 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 actually look like day to day?
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 like you drift to one side, or needing to touch a wall when you turn corners.
Legs that tire quickly when you stand still, such as in a queue or at a kitchen worktop.
Avoiding stairs, escalators or uneven ground because you do not trust your footing.
Struggling with a single-leg stance test, such as putting on socks or stepping into trousers.
What causes balance problems in adults?
Balance relies on three sensory systems sending the brain consistent information. When one or more falls out of step, you feel unsteady.
Conditions like BPPV or vestibular neuritis disrupt your sense of spatial orientation.
New glasses, cataracts or reduced peripheral vision change the visual cues your brain relies on.
Joint and muscle sensors 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 less often discussed is the structural side: how the position and alignment of your skeleton affects 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 compensate.
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 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 clinical term for how well your spine is balanced over your pelvis and legs is sagittal balance. Research shows that when sagittal balance is poor, falls risk rises, particularly in older adults. The challenge is that standard lying-down imaging does not capture this. When you lie on a scanning table, gravity is removed, muscles relax, and the alignment picture can look very different from what actually happens when you are on your feet.
How is balance-related alignment assessed standing up?
A standing whole-body EOS scan captures your skeleton from head to feet while you bear your full weight. This is important for balance problems because it shows where your centre of mass sits relative to 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 compensations your body has made.
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 investigations are usually more appropriate. Your GP or consultant can advise which you need.
What can you do about balance problems?
Improving balance usually involves a combination of approaches. Having the right information is the starting point.
- Targeted exercises. Strength and balance training, such as single-leg stance practice, heel-to-toe walking and gentle resistance work, can reduce falls risk. A physiotherapist can tailor a programme to your needs.
- Vision 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 reveal 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 clinician the standing alignment data that lying-down imaging misses. ScanAlign standing EOS imaging shows the full picture so decisions about your care are better informed.
Frequently asked questions about balance problems
Walking demands 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, which can make you feel unsteady, especially on uneven ground or when you are tired.
Some decline in balance is common with age due to reduced muscle mass, slower reflexes and changes in proprioception. However, frequent unsteadiness is not something you simply have to accept. Identifying the contributing factors, 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 altered movement patterns. Over time, this reduces your stability and increases postural sway.
It is an EOS scan that images your entire skeleton from head to feet while you stand upright and bear weight. This captures how gravity and your muscles affect alignment, something lying-down scans 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 refer yourself directly and start with a free video consultation to discuss whether a standing scan is appropriate for you.
Pricing information is available on our booking page. You can also book a free video consultation to find out more before committing.
Dizziness typically involves a spinning sensation (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. They can overlap, so see your GP if you are unsure.
Yes. Evidence-based balance and strength exercises, such as those in programmes recommended by the NHS Falls Prevention service, can significantly reduce falls risk. 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 to 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. 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.