Imbalance or Floating Feeling Symptom, Causes & Questions

Temporomandibular joint (TMJ) dysfunction disorder

Temporomandibular joint (TMJ) dysfunction disorder refers to long-term pain and dysfunction in the TMJ, the joint that connects the upper and lower jawbones.

The TMJ is a complex joint with complicated movements and is subject to strain and injury. Symptoms may come and go for no apparent reason. Misalignment of the teeth and jaw, and tooth grinding, are no longer believed to be a cause. Women seem to be more susceptible than men.

TMJ disorder has three types:

• Pain or discomfort in the muscles controlling the TMJ.
• Dislocation or injury to the jawbone.
• Arthritis of the TMJ.

Diagnosis is made through patient history, physical examination, and imaging. The goal is to rule out other causes such as sinus infection or facial nerve damage.

Due to the difficulty of diagnosing TMJ disorder, treatment begins with conservative methods that do not permanently change the jaw or teeth. Ice packs, soft foods, gentle stretching of the jaw muscles, and reducing stress are all encouraged. Short-term pain medications may be used. Splints, Botox, implants, and surgery are not recommended.

Rarity: Common

Top Symptoms: dizziness, pain, restricted movement, and clicking sounds from jaw, history of headaches, jaw pain, pain in the back of the neck

Symptoms that always occur with temporomandibular joint (tmj) dysfunction disorder: pain, restricted movement, and clicking sounds from jaw

Urgency: Primary care doctor

Post-concussion syndrome

Concussion symptoms tend to last for a few days to weeks. Sometimes, symptoms are long term, lingering for several months or even years. This is known as post-concussion syndrome (PCS). Some of the most common PCS symptoms include headaches and confusion. Memory problems and difficulty concentrating may also occur.

You should consider visiting a medical professional in the next two weeks to discuss your symptoms. A doctor can evaluate PCS with a review of your symptoms and an MRI. Once diagnosed, treatment depends on your specific symptoms but often focuses on letting the brain rest and recuperate. You may be asked to temporarily stop sports and exercise until you are cleared to return.

Non-urgent tinnitus needing hearing tests

Tinnitus is the medical term for ringing in the ears. is always a symptom of another disorder and is not a disease in itself.

Tinnitus occurs when nerves within the ear are damaged by prolonged exposure to loud noise or to certain drugs. The disrupted activity in the nerves causes them to overreact and produce the sounds known as tinnitus. When nerves are damaged enough to cause tinnitus, there will also be some degree of hearing loss.

Symptoms of tinnitus include a ringing, buzzing, or high-pitched whining sound within the ears. The hearing loss may or may not be noticed by the patient.

Tinnitus is not serious in itself, but can interfere with quality of life. There are treatments that can help with the discomfort it causes.

Diagnosis is made through physical examination and hearing tests.

Treatment involves use of a hearing aid, which can better conduct normal sounds across the damaged nerves of the ear; and treating any underlying conditions, such as high blood pressure.

Rarity: Common

Top Symptoms: ringing in the ears, ear pain

Symptoms that always occur with non-urgent tinnitus needing hearing tests: ringing in the ears

Symptoms that never occur with non-urgent tinnitus needing hearing tests: heartbeat sound in the ear, ear discharge, vertigo (extreme dizziness), face weakness, ear pain

Urgency: Primary care doctor

Meniere's disease

Meniere's disease is a disorder of the inner ear that affects balance and hearing.

Meniere's disease is due to an abnormality in the inner ear that results in low levels of fluid, thus interfering with the sense of balance. The abnormality may be hereditary or it could be from allergies, autoimmune disease, or other illness.

Symptoms usually affect only one ear and include severe attacks of vertigo, or the sensation of spinning; tinnitus, or ringing in the ear; pressure inside the ear; and increasing deafness. These symptoms are unpredictable and can come and go without warning.

Meniere's disease is progressive and will not go away on its own. It can lead to a severe loss of hearing and balance, and so a medical provider should be seen at the earliest symptoms.

Diagnosis is made through patient history; physical examination; hearing tests; and balance tests.

There is no cure for Meniere's disease, but it can be treated with motion sickness and anti-nausea medicines, hearing aids, and occasionally surgery.

Rarity: Uncommon

Top Symptoms: nausea, ringing in the ears, vertigo (extreme dizziness), ear fullness/pressure, brief fainting episode

Symptoms that always occur with meniere's disease: dizziness: at least 2 episodes

Urgency: Primary care doctor

Inner ear infection (labyrinthitis)

An inner ear infection, also called labyrinthitis, affects the delicate bony structures deep within the ear.

Labyrinthitis usually follows a viral infection such as the common cold, influenza, mumps, or the measles. In rare cases, usually in young children, it can be caused by bacteria.

Risk factors include a middle ear infection; meningitis; or any autoimmune disorder.

Symptoms include vertigo, where the person feels that the world is spinning around them; nausea and vomiting; some loss of hearing; ear pain, sometimes with drainage from the ear canal; and ringing in the ears (tinnitus.)

Viral symptoms may at least partially resolve on their own, but treatment can rule out a more serious condition as well as address the pain and discomfort. Bacterial labyrinthitis is often more serious and can cause permanent hearing loss.

Diagnosis is made through patient history, physical examination, and sometimes a hearing test.

Treatment for viral labyrinthitis includes rest, fluids, and over-the-counter pain relievers. Antibiotics will be prescribed for bacterial labyrinthitis.

Rarity: Rare

Top Symptoms: nausea, headache, diarrhea, vomiting, fever

Symptoms that always occur with inner ear infection (labyrinthitis): vertigo or imbalance

Urgency: Primary care doctor

Earwax blockage

Ear wax production is a normal process, as the body makes wax to protect the ear from infection. Sometimes ear wax can build up and cover the eardrum, which is a thin layer of skin that stretches across the end of the ear canal and picks up sound from outside. Ear wax buildup has nothing to do with poor hygiene, and it is not possible to prevent a build-up by washing.

You should go to a retail clinic to be treated. You should NOT try removing the wax with cotton swabs, because you run the risk of pushing the ear wax further into the ear canal, and potentially damaging the ear canal or eardrum. A variety of ear drops exist that can be bought at the pharmacy, such as Debrox, Murine, and Cerumenex. You may also use other remedies such as mineral oil, baby oil, or glycerin ear drops instead of brand-name drops.

Rarity: Uncommon

Top Symptoms: dizziness, dry cough, ear canal pain, ear fullness/pressure, ringing in the ears

Symptoms that never occur with earwax blockage: swollen ear, fever

Urgency: Phone call or in-person visit

Brain tumor or mass

In medical terms, "mass" and "tumor" mean the same thing: the unexplained, out-of-place growth of tissue anywhere in the body, including the brain.

The cause of any sort of brain tumor is unknown. Some originate in the brain, while others spread from cancers growing in other parts of the body.

Symptoms may include increasing headaches; nausea and vomiting; blurred or double vision; loss of sensation in an arm or leg; loss of balance; confusion; speech difficulties; or seizures.

If symptoms persist, it is important to see a medical provider so that any treatment can begin as soon as possible.

Diagnosis is made through neurological examination, CT scan, and/or MRI.

If the mass or tumor is found to be benign, that means it is not cancer and not harmful. It may or may not be treated.

If it is malignant, that means it is cancer and must be treated. This will involve some combination of surgery, radiation therapy, and chemotherapy, followed by specialized therapy to help with recovery.

Rarity: Rare

Top Symptoms: fatigue, headache, nausea, loss of appetite, irritability

Symptoms that always occur with brain tumor or mass: focal neurological symptoms

Urgency: In-person visit

Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo, or BPPV, is a common cause of vertigo –dizziness whenever the position of the head is significantly changed.

BPPV may occur after a head injury, whether minor or serious; or it can be caused by inner ear damage, which affects balance.

Most susceptible are women over 50, though it can happen to anyone at any age.

Symptoms include mild to intense dizziness or spinning; loss of balance; nausea; and sometimes vomiting. Flickering, jerking eye movements called nystagmus often occur at the same time.

Though BPPV is not dangerous in itself, it can cause falls and interfere with quality of life. If the dizziness occurs with severe headache, vision changes, trouble speaking, or paralysis, take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination, particularly looking for nystagmus. Specialized eye tests and imaging may be done.

BPPV may eventually resolve on its own. If not, therapy to adjust the sensitivity of the inner ear may be done, and in some cases surgery is effective.

Rarity: Uncommon

Top Symptoms: nausea, episodic dizziness, vomiting, vertigo (extreme dizziness), dizziness

Symptoms that always occur with benign paroxysmal positional vertigo: episodic dizziness

Symptoms that never occur with benign paroxysmal positional vertigo: hearing loss, heartbeat sound in the ear, ringing in the ears

Urgency: Primary care doctor

Atrial fibrillation

Atrial fibrillation, or AFib or AF, is a rapid, quivering, abnormal heartbeat. It occurs when electrical signals in the two upper chambers of the heart do not coordinate with signals in the two lower chambers.

Heart damage from high blood pressure, congenital heart defects, viral infections, and sleep apnea can cause atrial fibrillation. Other risk factors include increasing age, obesity, family history, and drinking alcohol.

The patient may notice a jerky, fluttering heartbeat; shortness of breath; and weakness. Chest pain is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Untreated atrial fibrillation may lead to heart failure. Blood clots can form in the stalled circulation within the quivering heart, travel to other parts of the body, and cut off the blood flow to other organs.

Diagnosis is made through electrocardiogram, echocardiogram, blood test, stress test, and chest x-ray.

Treatment involves cardioversion with mild electrical shock or medication to return the heart to normal rhythm. Surgery may be done. Blood thinners and medication to maintain heart rhythm will be prescribed.