How Can You Avoid the Risk of a Fall? Find Out How Balance Testing Can Help.


Grandmother out for a bike ride with her daughter and grandaughter

Yikes! Your risk of falling increases 140% for every 10 decibels of hearing loss, which means even mild hearing loss can triple your risk of falling

Balance problems can be disorienting, unpleasant and can increase your risk of falling. Because the ear plays a pivotal role in your equilibrium, many balance disorders can be traced back to problems within the inner ear. 

Balance testing helps determine how well your inner ears are functioning and communicating with the balance centers of your brain. If you’re experiencing vertigo or dizziness, for example, balance testing can help you identify the root cause and get you steady on your feet again.

What are the top types of balance testing?

Because there are several different causes of balance issues, we use a variety of diagnostic tools. 

Videonystagmography (VNG) testing

If you suffer from nystagmus, or involuntary eye movements, this can make you feel dizzy and off balance. A videonystagmography is a test audiologists use to see if you have nystagmus and which part of the brain is causing this disorder.

During a VNG test, you will sit in a dark room and wear special goggles. The goggles have a camera that records eye movements. The first portion of the test is ocular testing, where you will watch and follow moving dots on a light bar.

Next, we will do positional testing, where your provider will move your head and body in different positions to see if we can trigger the nystagmus.

The last part is caloric testing, where warm and cool water or air will be put in each ear. In a healthy vestibular system, the eyes move certain ways depending on the type of stimulant we insert. If your eyes do not follow the norms, this could be an indication of vestibular system issues.

Electronystagmography (ENG) testing

Electronystagmography (ENG) is often referred to as “Balance Testing.” ENG is popular in part because it’s also incredibly flexible. ENG diagnostics can test for a multitude of balance disorders.

During an ENG test, you will be fitted with special goggles or a headpiece. This device will be equipped with tiny cameras that will closely watch and monitor your eye movement. By exposing your eyes to various types of visual stimuli, ENG diagnostics can collect a wide range of data concerning how you and your body handle balance.

Electrodes placed on the head will also collect data regarding how your inner ear is collecting and transmitting electrical signals. That way, if there’s a problem with the inner ear, the diagnostic will identify it. 

During your ENG test:

  • Electrodes will be placed on your forehead and around your eyes. 
  • Cameras will be positioned to closely monitor and record your eye movements.
  • During the test, you’ll probably be asked to look up, down, or follow the movements of a dot of light. Some tests may vary. For example, you might first be asked to watch a stationary white dot against a black background. The progression of visual tasks will change depending on your symptoms.
  • Your ear may be exposed to water or warm air, depending on the type of test.
  • All of the data gathered will be recorded and fed into the diagnostic device. Your specialist can use this data to make a diagnosis or refer to more testing.

After your ENG test, you should avoid rubbing your eyes (paste is used to attach the electrodes, and you don’t want to spread that paste around). While an ENG diagnostic is not in any way painful, you may experience dizziness or nausea both during and after the procedure. As a result, many individuals who come in for testing are instructed to ask a family member to drive them to and from the procedure. 

ENG testing can be used to uncover a wide variety of issues, including vertigo, inner ear problems, Meniere’s disease, and more.

Electrocochleography (ECOG) testing

A special diagnostic called electrocochleography (or ECOG) is used to measure the amount of electrical potentials in the cochlea as it responds to sound. In this way, an ECOG diagnostic is similar to a VEMP test. During an ECOG test, a specialist will be able to get a sense of the pressure in your inner ear and, as a result, detect any distention of the basilar membrane.

This can help balance specialists better understand the source and the cause of your dizziness or vertigo. During an ECOG test, you will:

  • Lie or sit in a reclined position.
  • Have an electrode placed on your forehead and a foam electrode placed in your ear canal.
  • Listen to the clicking sounds played during the test.

Some of the sounds may be loud, but an ECOG test should never be uncomfortable. There are no lingering effects from an ECOG test.

Vestibular Evoked Myogenic Potentials (VEMP) testing

In general, Vestibular Evoked Myogenic Potentials (or VEMP) testing is used to discover uncommon or unusual causes of your balance issues. This test is designed to monitor the signals sent between your inner ear and your brain. In particular, VEMP testing is looking at your vestibular nerve (located within your inner ear), which is responsible for sending balance-related messages to your brain.

During a VEMP test, you will:

  • Sit in a reclined position with electrodes placed on your and your neck.
  • Listen to knocking sounds.
  • Lift your head slightly in various directions.

The whole procedure usually takes 60 minutes or less. 

During the diagnostic, the VEMP testing will localize which side of your head (or which ear) is causing the balance issues. In this way, VEMP testing can be useful in diagnosing Meniere’s Disease, Superior Semicircular Canal Dehiscence, and Perilymphatic fistula.

VEMP testing is completely non-invasive, and there are no lingering effects.

Discover what’s causing your vertigo

If you’re having trouble with your balance, or you’ve experienced dizzy spells and bouts of vertigo, it’s definitely worth having your balance tested. These diagnostics are safe and painless. Some may induce a feeling of dizziness or nausea.

To find out more about balance testing and see if you’d be a good fit for one of these tests, give us a call today. Most tests can be completed in less than an hour, so you can come in, get your diagnostic and discuss your results in short order.

Mature couple doing yoga without the fear of falling.

How Are Balance Problems Treated?

First, we need to determine the cause of your balance issues, then we can recommend a treatment method. 

For example, your balance issues may require a therapist to create a treatment plan especially for you. The plan would include balance retraining exercises to strengthen your balance, increase your energy levels and reduce stress.

There are also positioning procedures – specific head and neck movements that clear the inner ear canal and often improve balance issues.

Diet and lifestyle changes may also improve your balance problems. This includes quitting smoking, as well as reducing salt, caffeine, alcohol, nicotine and chocolate. Simple exercises, including walking and low-impact aerobics, may help, as well.

There are anti-vertigo and anti-nausea medications available to relieve balance disorders. The antibiotic gentamicin, or even corticosteroids, can be injected behind the eardrum for those with severe balance problems.

Surgery may be required to alleviate your balance problems if you have Meniere’s disease or another medical issue that can’t be remedied using less invasive methods.