07/25/2013
Unsteadiness:
Unsteadiness can be defined as the inability to walk without need to focus attention on walking.
One of the usual ways that unsteadiness may occur includes nerve damage.
The first step of nerve damage causing walking problems and unsteadiness is the damage to the nerves furthest from the center of the body. The most distant nerves are also the smallest. The nerve damage can be due to a chemical imbalance in the body causing a “peripheral neuropathy (PN).” When significant PN has taken place, the brain can’t correctly automatically plan walking. To walk, the feet need to be wide enough to balance the body. Without nerve input, it is the equivalent of attempting to walk on stilts instead of on feet. The severity of unsteadiness may vary daily.
The process of nerves no longer sending enough information is gradual. Because it happens slowly, the problem of unsteadiness is also usually gradual. At first, the brain is able deal with the slowly reducing amount of information for a time. This means that when the exact moment when unsteadiness was first ever noticed may be lost over time. The amount of time it takes for nerve damage to cause unsteadiness varies from person to person. Having nerve damage doesn't automatically mean that there is pain in the feet and legs. Having nerve damage doesn't automatically mean that people become aware of numbness in the feet, either. Instead, the only symptom a person may have of nerve damage is unsteadiness. Fortunately, having nerve damage doesn't mean that unsteadiness takes place.
The diagnosis of unsteadiness is a made by both the patient and the physician in the exam room. Testing for nerve damage by EMG testing may also be helpful.
The treatment for unsteadiness usually is focused on the brain learning to re-create automatic walking since the nerve damage can’t be undone in most cases. The best approach for unsteadiness can be physical therapy which leads to people learning new techniques for balance while walking. Physical therapy should be geared to walking balance if nerve damage is the cause, not to be confused with physical therapy for retraining of the inner ear balance centers.