Today, the 22 September 2009 is National Fall Prevention Awareness Day. As such, many people are being told about the risk of falling and having an injury because of falls. I often see patients that have balance difficulties and wonder what the causes are. To examine this, I would like to explain the topic of balance:
1. Eyes --> Visual checks of the horizon or surrounding items can often preclude a fall, because you will physically notice that your are loosing your balance. This will cause other parts of the body to adjust. In dark areas or at night, the eyes are less valuable in providing this balance effect. In fact, if you have visual problems, you may also lose this benefit.
2. Ears --> In the inner ear, there are small cilia or hairs that provide the sense of balance. If the head tilts abnormally, these hairs send a signal that informs the brain of loss of balance. With auditory (ear) problems, these sensations may not function as they should. Hearing loss may represent loss of nerve function, including this sensation of balance.
3. Proprioception --> This is a large word that basically describes pressure to the feet. When you start to lean one way or the other, increased pressure is placed on a foot, and the brain is instructed that the legs or hips need to be adjusted to fix this balance problem. In diabetic neuropathy or other peripheral neuropathies, the feet lose the proprioception and an individual is unable to adjust how they stand or walk when losing balance. Prioprioception can be assisted, however with a cane or walker that places proprioception into the hands instead of the feet and allows the body to adjust for lack of feeling in the feet.
Neuropathy can be a large problem in falls and may lead to lack of balance. If treatments are utilized to improve neuropathy, proprioception (and balance) will also be improved. I recommend that anyone with neuropathy look for options to improve their balance, so that the 10% of serious injuries from a fall can be avoided.
For additional information on neuropathy and treatment options, please visit www.UtahFootDoc.com.
Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003