A stroke often causes weakness on one side of your body, which can make it difficult to balance. You may find it hard to sit up safely or you may have difficulty standing. You may be able to walk but find it difficult to lift or move your foot and toes quickly enough to stop them catching on the ground when you step. This is known as foot drop. It can make you feel unsteady or more likely to trip. 

Reduced feeling and awareness of your body’s position may make it more difficult to move and keep your balance, particularly with loss of sensation in your leg. This can increase your risk of having slips, trips and falls.

After a stroke, changes in your concentration and attention can make it harder to keep your balance and react to changes in your surroundings. Reduced focus can increase the risk of losing your balance or falling, especially in busy places or distracting situations. 

Many people who fall say they were thinking of other things, or doing several things at the same time. One example is walking and talking at the same time – you might find you need to stop walking if you want to listen or talk.

Vision is an important part of balance. Vision problems are common after stroke. They include difficulty focusing, double vision, eye movement problems and missing part of your field of vision (hemianopia). 

Vision problems can make it difficult to judge distances, see obstacles or stay aware of your surroundings. This can affect your balance and increase the risk of tripping or falling, especially when moving around unfamiliar or uneven areas. Our webpages on vision problems after stroke have more information on these problems. 

Have a regular eye test and wear glasses if you need them. Your optician can refer you for specialist help with vision problems.

You may experience vertigo if a stroke happens in the areas that control balance in the brain, the cerebellum and brainstem. Vertigo means having a feeling that you or the world around you are moving or spinning. You can feel dizzy or lose your balance more easily.

Spatial neglect, or inattention, happens when the brain does not process sensory information from one side of the body or your environment. You might find you bump into objects on that side. If it’s more severe, you may be unaware of that side of your body and the space around it. You may try to move but forget that one leg is weak or ignore that side altogether, which can cause you to lose your balance. 

Fatigue is common after a stroke. You may feel you lack energy and are constantly very tired, physically and mentally. This can make it harder to concentrate, move and stay alert and may affect your ability to keep your balance. Our fatigue after stroke webpages have more information. 

Ataxia refers to a lack of coordination and control over movement. This is often caused by damage to the cerebellum, which controls balance and movements. 

People with ataxia have difficulty with controlling smooth movements. Movements of your limbs and body tend to be shaky, and arms or legs can miss their target. This can make balance difficult when sitting and standing. If your steps are uncoordinated, your feet might not end up in the exact position you wanted. This can make it difficult to balance. 

Some people experience the sensation that they’re upright even when they’re leaning heavily to their weak side, sometimes to the extent that they cannot sit up safely. This is called ‘pusher syndrome’.

Some medicines may sometimes cause dizziness or drowsiness, which might affect your balance. This may include some types of high blood pressure medication or antidepressants. Interactions between different medicines can also affect your balance. 

Talk to your doctor, pharmacist or another healthcare professional if you have any concerns about your medication. You may be able to try new drugs or a different combination of drugs. Never stop taking any medication without speaking to a healthcare professional first.