Unsteady Gait

Most people will experience an unsteady gait (a person's pattern of walking) at some point in their lifetime, including when tripping over an obstacle, limping after an injury, or having difficulty with balance while intoxicated. However, these symptoms are temporary. An unsteady gait that is persistent can be a sign of an underlying health condition. It can also be a side effect of some medications.

This article discusses unsteady gait, what the symptoms are, potential causes, and how it is treated.

Symptoms of Unsteady Gait

The main symptom of an unsteady gait is being unbalanced while walking.

Depending on the underlying cause, other issues that may occur with an unsteady gait include:

• Loss of balance
• Dizziness
• Confusion
• Blurry vision
• Fainting
• Light-headedness
• Falls
• Vertigo (feeling like the room is spinning)

Causes of Unsteady Gait

An unsteady gait can occur with a develop from health conditions that affect the musculoskeletal system (muscles and joints), vestibular system (inner ear and brain), or the nervous system (brain, spinal cord, or peripheral nerves) that controls body movements. An unsteady gait can also occur as a side effect of certain medications.

Musculoskeletal Conditions

Conditions that affect joints and muscles in the legs can cause an unsteady gait. Examples include:

• Osteoarthritis (wear-and-tear arthritis)
• Ligament injury (sprain or tear)
• Muscle injury (strain)
• Fracture (broken bone)
• Leg length discrepancy
• Muscle weakness

These conditions can lead to pain, bruising, or swelling.

Musculoskeletal conditions are diagnosed by a physical examination. X-rays can also be taken to diagnose arthritis and bone fractures. Magnetic resonance imaging (MRI) can aid in diagnosing soft tissue injuries to muscles or ligaments.

Musculoskeletal conditions are often treated with nonsteroidal anti-inflammatory drugs (NSAIDs) to help decrease symptoms during the healing process. Physical therapy is commonly prescribed to address the unsteady gait that occurs with these conditions.

In some cases, surgery is required. Severe osteoarthritis in the hip or knee is frequently treated with total joint replacement. Significant leg length discrepancies might require leg-lengthening surgery.

Vestibular Conditions

The vestibular system is made up of structures in the inner ear and areas of the brain that interpret information from these structures.

Common vestibular conditions include:

• Benign paroxysmal positional vertigo (BPPV) (a form of vertigo)
• Ear infections (labyrinthitis, vestibular neuritis)
• Ménière's disease, also called primary idiopathic endolymphatic hydrops (inner ear disorder that causes vertigo)
• Vestibular migraine (a type of migraine whose primary symptom is vertigo)
• Secondary endolymphatic hydrops (caused by trauma, allergies, or another underlying condition, causing vertigo and intermittent hearing loss)
• Perilymph fistula (the inner ear fills with liquid due to a small tear)

Vestibular disorders are diagnosed through a variety of tests that assess the function of the inner ear. Examples include:

• Rotation tests (measures the brain's ability to mentally rotate objects)
• Vestibular-evoked myogenic potential (VEMP) (measures muscle reaction to repetitive pulses)
• Video head impulse testing (VHIT) (tests vestibular function)
• Computerized dynamic posturography (CDP) (used to diagnose balance issues)
• Electronystagmography (ENG) (examines nerve function in the brain by evaluating eye movement)
• Videonystagmography (VNG) (measures involuntary eye movement)
  

Vestibular conditions are typically treated with medications and/or vestibular rehabilitation exercises.

Neurological Conditions

A variety of neurological conditions cause unsteady gait. These conditions affect the brain, spinal cord, or peripheral nerves that travel through the legs.

Examples include:

• Stroke
• Brain tumor
• Parkinson's disease
• Amyotrophic lateral sclerosis (ALS)
• Huntington's disease
• Spinal muscular atrophy
• Alzheimer's disease
• Lewy body dementia
• Peripheral neuropathy
• Multiple sclerosis

Diagnosis of these conditions begins with a neurological exam by a healthcare provider. This includes assessment of movement, sensation, hearing, sight, speech, coordination, and balance. Lab tests are often performed to analyze blood, urine, or saliva to look for infections, antibodies, or toxins.

Other diagnostic tools used to identify neurological conditions include:

• Ultrasound
• Positron-emission tomography (PET) scan
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan
• Angiography
• Electroencephalography (EEG)
• Electromyography (EMG)

Treatment for neurological disorders is condition-specific but often includes medication. In some cases, surgery may be required.

What Medications Can Cause Unsteady Gait?

Unsteady gait and balance issues can be a side effect of a variety of medications. Examples include:

• Antidepressants
• Opioids
• NSAIDs
• Anti-arrhythmics
• Vasodilators
• Diabetes medications
• Anti-anxiety drugs
• Sleep aids
• Blood pressure medications
• Anticholinergics
• Antispasmodics
• Antihistamines

If you suspect that your medication might be causing an unsteady gait, ask your healthcare provider about possible alternatives.

Summary

An unsteady gait can be a temporary side effect of an injury or intoxication, or it can be a sign of a more serious underlying condition. An unsteady gait can be a result of issues with the musculoskeletal, vestibular, or nervous systems. It can also be a side effect of medication. Treatment of unsteady gait includes medication, physical therapy, and sometimes surgery.

A Word From Verywell

An unsteady gait can be a problem with a simple fix or be a sign of a more serious health condition. Seeing your healthcare provider is the first step in determining the cause of your symptoms. In the meantime, reduce your risk of falls by making some small changes to your environment: Remove throw rugs, add light to dark areas such as hallways, and wear shoes with nonslip soles when you're inside.