Can a hearing aid improve balance?

Q: Can poor hearing affect balance?

Quite a few things can lead to balance problems, but its a lesser-known fact that hearing loss can cause balance disorders. Our ears are involved in more than just hearing, and the presence of the semicircular canals in our ears can lead to balance problems in people suffering from hearing loss.

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Hearing Aids and Balance
Hearing Loss Can Be Managed And Treated.
Can poor hearing affect balance?
Can hearing aid reduce vertigo?
How does hearing help with balance?
Can an audiologist help with balance problems?

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Hearing aids may help improve your balance and reduce the risk of falls. Find out more about the connection between hearing aids and body steadiness.

Do you often find yourself bumping into things or falling? It could be related to hearing loss. Studies have shown that hearing loss affects your balance and increases your risk of falls. Fortunately, using hearing aids may help improve your stability. Learn more about the role of hearing aids in improving balance.

Hearing Aids and Balance

“Our ear is an important organ in our body—not only does it process the sound we hear through the cochlea (inner ear), but it also houses our vestibular system, which is responsible for helping our bodies maintain its balance,” Rhee Nesson, AuD, founder of Hearing Doctors of New Jersey, tells WebMD Connect to Care.

“When any part of our ear is compromised, for example, due to hearing loss, it can lead to balance disorders,” Nesson adds.

According to the American Speech-Language-Hearing Association, even a mild degree of hearing loss can increase your risk of an accidental fall by nearly three times. And this risk may rise by 140% with every additional 10 decibels of hearing loss.

The American Speech-Language-Hearing Association also notes that there are three theories that may explain why hearing loss affects balance:

Hearing loss reduces your awareness of the environment around you. Therefore, you may not notice other people, things, or activities near you.
Hearing loss reduces spatial awareness, so you may find it difficult to assess how far your body is in relation to objects around you.
When you have hearing loss, your brain tries hard to listen and interpret speech and utilizes more resources, so fewer resources are left in the brain for maintaining balance and stability.

Fortunately, treatment in the form of hearing aids may improve your balance, according to a recent investigation by American researchers at the Washington University School of Medicine in St. Louis. In 2015, they published a study in The Laryngoscope that evaluated the balance of 14 people with hearing loss who were aged 65 to 91.

Researchers found that patients scored higher on standard balance tests when their hearing aids were worn in both ears and turned on, versus when the hearing aids were turned off. This was the first study to establish that sound information, independent of the balance system contained in the inner ear, contributes to the body's maintenance of balance.

“Hearing is one of the senses our body uses to optimize our balance,” Sarah Lundstrom, AuD, an audiologist at HearCare Audiology Center in Venice, tells WebMD Connect to Care. “Hearing provides good information on the location and distance of sounds, which help us assess our position and movement.”

“Wearing hearing aids helps with not only reconnecting with your family and loved one's by hearing better, but it can also improve your balance. By treating your hearing loss now, you can improve your overall quality of life and minimize your risk of falling,” Nesson says.

Hearing Loss Can Be Managed And Treated.

The earlier you address the symptoms of hearing loss, the more likely you are to avoid irreversible damage. Get the answers you need to start treatment today.

McDaniel, D. Mike PhD; Motts, Susan D. PhD; Neeley, Richard A. PhD, PT

From left, Dr. McDaniel and Dr. Neeley are professors of communication disorders at Arkansas State University (ASU), where Dr. Motts is an associate professor of occupational therapy. Dr. McDaniel is a life member of ASHA. Dr. Mott's research includes brainstem neural circuitry and photobiomodulation. Dr. Neeley served as the program director of ASU's Communication Disorders department for 16 years.

The possibility of using conventional hearing aids and other amplification techniques to enhance the postural integrity and/or balance of people with hearing loss is alluring but, for the present, such claims are potentially misleading. Two recent studies, using similar research designs and relatively small sample sizes, resulted in entirely different conclusions (Laryngoscope. 2015 Mar;125(3):720; Am J Audiol. 2018 Jan 21:1). Results from the Rumalla, et al., study, though failing to reach statistical significance, led the authors to speculate that the use of hearing aids was a novel treatment modality for individuals with hearing impairments and concurrent balance or postural disorders (Laryngoscope. 2015). McDaniel, et al., concluded that hearing aids did nothing to positively (or negatively) affect balance in participants who used them (Am J Audiol. 2018).

Both studies used a within group (i.e., one group of participants) of experienced hearing aid users who were assessed with and without their hearing aids. McDaniel, et al., used balanced testing conditions to guard against order effects. Rumalla, et al., utilized a pseudorandomized set of conditions (aided or unaided) and trials. The primary difference between the two studies was the method by which balance was quantified. Rumalla, et al., utilized the Romberg on Foam test and the Tandem Stance test, both of which are timed screening tools. McDaniel, et al., used computerized posturography (i.e., the Sensory Organization Test) performed on a NeuroCom Balance Master. Both studies share similar limitations concerning convincing sample sizes and criterion for participation selection. Their relatively small sample sizes raise the question of statistical power, thereby increasing the possibility of a type II error. This limitation may have masked a true difference between the aided and unaided conditions. Additionally, the use of only older adults with some hearing aid experience and no diagnosed balance disorders limits the population to which results can be generalized.

There are notable empirical evidence on hearing aid benefit with regard to quality of life and cognitive preservation. Lacerda, et al., observed improvements in the quality of life gained from auto-confidence with auditory prosthetics that reduce the fear of falling (Int Arch Otorhinolaryngol. 2012 Apr; 16(2): 156). Wingfield and Peelle reported that “time-consuming, large-scale, long-term, prospective, longitudinal studies are likely needed to clarify the potential benefit of hearing aids for maintaining cognitive function” (Aging health. 2012 Apr; 8(2): 107).

Research on the potential benefit of hearing aid use in improving balance appears to mirror the research on whether hearing aid use can maintain or improve cognitive function and quality of life.

McDaniel, et al., urged that “…caution should be exercised by hearing aid dispensing clinicians as they counsel potential hearing aid users that amplification (i.e., hearing aids) might improve their balance.” As hearing health care providers, an additional level of caution should be encouraged. Restraint should be exercised, and everyone in the industry should be vigorously encouraged to follow suit. Unfortunately, there is evidence that this restraint is not being fully utilized. One has only to google “hearing aids and balance improvement” to find an array of potentially misleading headlines.

D. Mike McDaniel, PhD

Richard A. Neeley, PhD, PT

Susan D. Motts, PhD

Can poor hearing affect balance?

Quite a few things can lead to balance problems, but it's a lesser-known fact that hearing loss can cause balance disorders. Our ears are involved in more than just hearing, and the presence of the semicircular canals in our ears can lead to balance problems in people suffering from hearing loss.

Can hearing aid reduce vertigo?

Hearing aids might help some people with vertigo symptoms since sound can help a person orient themselves and navigate their environment — but hearing aids are not a treatment for vertigo itself, Palmer advises.

How does hearing help with balance?

Loop-shaped canals in your inner ear contain fluid and fine, hairlike sensors that help you keep your balance. At the base of the canals are the utricle and saccule, each containing a patch of sensory hair cells.

Can an audiologist help with balance problems?

If you are experiencing dizziness or any type of imbalance, an audiologist will first test your hearing and examine your ears. They can provide balance testing to help identify the cause of your balance problems and/or dizziness. Based on this information, they can make recommendations for treatment.