Balance Problems in MS

The cerebellum is located in the lower-back region of the brain, and helps to control movement, coordination, balance, and muscle tone. While demyelination in this area can cause tremor for some individuals, it can cause balance problems as well. Other components, such as vision, hearing, and movement of the arms and legs, are also involved in balance. Problems with the functioning of any of these areas can worsen balance, but conversely, some of these areas may be able to compensate for other deficits in balance.

Unlike tremor, balance cannot be treated with medication. The only therapy for balance is through exercise. Physical and occupational therapists will often use an exercise known as patterning when treating balance issues. With patterning, the therapist guides the patient through repeated movements with the idea of retraining the muscles to gain more control and coordination while moving in that same pattern.

Another technique, known as vestibular stimulation, uses motion such as rocking, swinging, or spinning to challenge the brain stem where balance can be affected. This added stimulation helps the balance centers of the brain to function better. Another therapy that may be helpful for individuals who can stand is the SMART Balance Master®. Using a computer, this balance stimulation program tracks the movements of the patient’s feet on the screen and helps to teach the patient how to improve his or her balance.


Schapiro, R. T., Managing the Symptoms of Multiple Sclerosis, 5th edition, (Demos Medical Publishing, 2007)

Reviewed by Randall T. Schapiro, MD
President, The Schapiro MS Advisory Group
Clinical Professor of Neurology, University of Minnesota (retired)

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