Balance & Gait Problems: A Real Puzzler
Hello, all!
I'm a 77-year-old retired male. Although I'm generally healthy, I have balance and gait problems. They snuck up on me sneakily, starting (I'm guessing) about ten years ago. They've been manageable until recently (the past 1-2 years); if I were just careful, I'd be okay. Lately, I suspect they're getting worse. (I've fallen twice in the past few months.) My doctor has been puzzled because I have no dizziness (no pain either); everything from my waist up seems A-okay; the lower half of me seems to be the problem. And the lower half of me does have some "issues." My right knee is prosthetic, and my left is arthritic. My orthopedist tells me my 12-year-old prosthetic is in good shape, and my arthritic knee, though occasionally painful, can still be managed with injections. I have seriously flat feet (pronated), for which I have been wearing orthotics for nearly 30 years. The last time I saw my podiatrist, I asked if my bad might be contributing to my balance and gait problems; he thought no, that I still have good circulation and nerve response. At my wit's end, I met with a neurosurgeon, thinking my difficulties might be all "in my head." Two MRIs––brain and cervical spine––showed only "borderline" cervical myelopathy, which the surgeon thought wasn't operable; nor did he think it was the cause of my get-around difficulties. So, I'm at a loss as to where to turn next. Tuesday, I'll be meeting with my primary doctor to go over all of this. I suspect I'll be giving her a real puzzler. I thought I'd post here on the off-chance that others have had similar difficulties figuring out what was causing their balance and gait problems.
Ray (@ray666)
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Hi Ray @ray666, @sueinmn shared a post about having similar problems with her gait here -- https://connect.mayoclinic.org/comment/635851/ and may also be able to offer some suggestions.
Hi, John @johnbishop Thank you for this! I will definitely follow up. As you probably gathered from my post, I'm a little on edge about again discussing my gait with my primary. She and I have discussed this so often over the years. I even asked her one time if she knew of a specialist, someone akin to a holistic practitioner, who would take into account all of my body's maladies, to see if it might be a composite that's causing my unsteady gait. Again, thank you for spotting my post! ––Ray @ray666
Hi Ray, Hoping it works for you as well as it did for @sueinmn. Sounds like it was a lot of work but well worth it.
Hey Ray! Thought I’d pop in with my 2 cents worth.
I had issues with my spinal cord a few years ago. Lost my ability to walk for a bit which led to obvious issues. (Side effect of my transplant) When I was back on my feet, I felt really frail, my gait was off and my walking stability was just weird. My transplant team jumped on this with a trip to a physical therapist. Wow, she worked with me for several weeks, giving me exercises to improve my core muscles and my balance. That worked miracles within 2 weeks!
There are simple ways to test your balance at home to see if this might be at the core of the problem…no pun intended. 😅 https://video.search.yahoo.com/search/video?fr=yfp-t&ei=UTF-8&p=Ways+to+test+your+balance#id=2&vid=13401e71967e403cbe6fc71ba96b9828&action=click
As for your holistic approach to your problem. https://www.mayoclinic.org/departments-centers/integrative-medicine-health/sections/overview/ovc-20464567
Have you ever considered integrative medicine?
Hi, Lori! Great to hear from you! Yes, I have this "issue," too. When it rains, it pours, eh? I've copied your message into Work so I can answer it a little later. To cut down on distractions, I use an Internet blocker, and it's about to cut me off. So, more later! ––Ray
Hi, Lori (@loribmt)
It's great to cross trails with you here on the Mayo campus! My BM issues are on again, off again, but recently it's been my gait difficulties that have been topmost on my mind. You certainly have had your own share of difficulties, more serious than mine, that's for sure. You mention a problem with your spinal cord and losing your ability to walk. My gait troubles started about ten years ago, merely a nuisance at first, but then growing in frequency and severity over the years. As you might have gathered from my posts, I've been referred to a variety of doctors. Each doctor would suggest a probable cause and therapy approach narrowly focused on his or her specialty. All, too, would send me into PT. Each therapy approach seemed to help, but only "a little," none proved to be a full and lasting solution. I was left without a name for what was wrong. Then, six months ago, I was referred to a neurosurgeon. I thought: At last, the right doctor! I thought too: At least I'll have a name for what ails me! But several MRIs resulted in a diagnosis of "borderline" cervical myelopathy, not serious enough to warrant surgery; the neurosurgeon was honest enough to tell me that the myelopathy might not even be the cause of my gait problems. That leads me to today, still at a loss as to what's giving me a wobbly walk. That's also why yesterday I thought I'd return to Mayo Connect, to learn of others' experiences. I've not had a chance yet to try the links you sent, but I will, as soon as I'm back online. And "integrative medicine" has an intriguing sound. I'm looking forward to learning about that, especially before I meet with my primary next week.
Ray (@ray666)
I had gait issues and my MRI showed a bulging disc close to, but not touching my spinal cord. However, the clinical observations pointed to myelopathy. My orthopedic spine surgeon ordered a flexation study that revealed a vertebra striking the spinal cord when my neck was flexed.
Ray (@ray666)
Do you have pain anywhere other than where you mentioned … like pain in lower back or pain in inner thigh or in your leg?
I took care of my mom for awhile and her gait & balance was off. She would walk using her walker and it looked like her knees just buckled and went in a sit-down position that turned into a fall down. It is an unusual way to fall. It turned out to be her sacral joint. She was in her early 90s and just nothing they could do.
Then a couple of years later and I catch myself about to fall in the same manner. I have back pain from a previous surgery.. L-S joint ... the hardware seems to be rubbing me wrong. I started hurting a bit lower than my L-S joint and had some pain in my inner thigh. I went to my pain specialist and he said it was my sacral joint. He did a SI joint fusion and things got better. .. no sit-down incidences since. When the sacral joint causes problems the symptoms can be vague or pronounced. It can cause bladder and bowel problems… and can exist along side of pelvic disorders. I had bladder prolapse happening the same time.
It seems I never have just one physical problem to try to get a handle on. I have had neuroma surgery and another neuroma in my right foot and broke my little toe of my left foot right at the joint. I was diagnosed awhile back with bone on bone arthritis in my right foot across the pad.. effecting all toes and ball of foot. I suspect my left foot not far behind. I have a bum right knee .. many years ago the kneecap tilted off to the side and I had to have a release. I still do exercises for my knee. .. but still hurts. Even though I try not to I limp… I limp. Sometimes I feel like I waddle like my bowlegged grandma did. It does not seem like it takes much for the balance and gait to go off kilter.
Hopefully you will find the answer to your gait problem soon.
ZeeGee
Good morning! You mention a flexation study. That's interesting. Although my surgeon gave me that "borderline" diagnosis, he never mentioned any sort of follow-up study, only that I do lots of cervical PT, which I have been doing. Had you any pain prior to the diagnosis that revealed a bulging disc? ––Ray
I had so much pain elsewhere in my lower spine that I really didn't notice the pain in my neck. I was really surprised at how much less my neck hurt after the procedure.