If you’re living with multiple sclerosis (MS), you may find that sometimes it’s difficult to maintain your balance, causing you to fall down. In fact, more than half of people with MS report falling during the prior six months — and falls can result in dangerous injuries.

“I recently started losing my balance and falling,” one MyMSteam member wrote. Another said, “Three weeks ago I fell and broke the top end of my right humerus. It makes everything that already takes more effort than I have even more difficult.”

Falls can lead to injuries, stress, and a lower quality of life, so it’s important to prevent them whenever you can. Check out five ways you can stop falls before they happen.

1. Work With a Therapist on an Exercise Program

Balance issues are often responsible for falls and can be worsened by walking difficulties, fatigue, and leg weakness. A physical therapist and your neurologist can design an exercise program that will help you gain strength, reduce fatigue, and improve your balance so you aren’t as likely to fall.

One study of 32 people with multiple sclerosis found that the number of falls decreased nearly fourfold after participants performed therapist-led exercise sessions for seven weeks. The hourlong sessions included balance exercises that targeted core stability, multitasking, and sensory strategies.

Exercise has also been shown to reduce fatigue in people with MS, which could help you stay more alert when walking so that you aren’t as likely to fall. In addition, physical movement can reduce the effect known as deconditioning, which occurs when your muscles and nerve fibers get weak because you haven’t used them.

Your physical therapy team might suggest several types of exercise to help improve your balance. Some people with MS find that practices like tai chi and yoga lead to better balance and agility.

Research shows that tai chi — a Chinese martial art that involves deliberate, slow movements — may improve balance, walking, flexibility, and leg strength among people with MS. Some research has suggested that yoga — poses combined with deep breathing exercises — also helps reduce balance issues associated with multiple sclerosis.

Always talk with your neurologist before starting an exercise program to ensure that it’s safe for you. They can refer you to a physical therapist specifically trained in helping people with MS.

2. Treat Vision Impairments Whenever Possible

If you have balance issues, you can’t afford to have other fall risk factors in your life as well. For example, people with MS may develop vision problems, such as blurriness, optic neuritis, and double vision. Another eye issue that can affect people with MS is known as nystagmus, which causes uncontrolled, repetitive eye movements. This problem can make balance and coordination problems even worse, compounding your risk of falling.

See an ophthalmologist, along with your neurologist, to evaluate which treatments might help you manage your vision problems. Depending on your eye issue, a health care provider may suggest steroid treatment to reduce inflammation and prevent optic nerve damage. If you’re experiencing double vision, your care team might recommend attaching a Fresnel prism to your glasses. This device realigns images before they hit your eye so that you stop seeing double.

If you have vision problems, try not to walk without assistance so you don’t risk falling. “I fell last week because my field of vision suddenly turned to black,” one MyMSTeam member wrote. “It’s never happened before or since, but if it happens again, I’ll stop what I’m doing and sit down right where I am so I don’t fall.”

3. Consider Using a Mobility Aid

Some people with MS find that using a mobility device can reduce falls by keeping them stable, even with balance issues. The right assistive devices depend on your needs, capabilities, and strength, so talk to a neurologist about what might be the best choice for you.

Braces

Using a brace may help stabilize the body part that makes you liable to fall. For instance, an ankle foot orthosis will help keep your ankle stable, which may help manage foot drop — when your foot muscles are too weak to lift while walking. Wearing an orthosis holds your toes in position so that they’re less likely to catch on something such as a rug, prompting a fall.

Canes and Walkers

A walking aid like a cane or walker can help you stay upright even if dizziness strikes. People with MS who may not need assistance all the time often appreciate the security of a cane, which gives them something to lean against if balance issues hit. Walkers also provide stability but offer a wider base of support than canes do. Wheeled walkers, known as rollators, don’t require lifting, and they roll smoothly to help you walk with stability.

Wheelchairs and Scooters

If falls are becoming more common, you might consider using a wheelchair — either manual or motorized — so you don’t have to stand as often. Also popular are motorized scooters, which can be slimmer than a wheelchair and often have handlebars, making them easier to steer for some people.

Keep in mind that using a mobility aid doesn’t mean you’ll never fall down. Research indicates that people who use mobility aids are still at risk of falling. It’s important to be trained on how to use your device properly, and combine its use with other strategies to avoid falls.

4. Cut Down on Clutter

Decluttering your home, office, or anywhere else you spend significant time can cut your risk of tripping. One study noted that when individuals with MS reduced clutter, they reported fewer falls and better quality of life.

Even if your house doesn’t feel cluttered, it’s important to look around for areas that may put you at risk of falling. “I picked up the rug in my living room because my foot kept catching on the edge of it and tripping me up,” one member wrote. “Cute as it was, I’d rather not fall on it again!”

If you need help determining which areas put you at risk of falls, consider asking your neurologist for a referral to an occupational therapist, who can suggest modifications to your home or workplace that can help reduce your fall risk. They may point out places you could install grab bars or handrails or make other adaptations to support you when your balance is off, allowing you to prevent future falls.

5. Anticipate Falls During Flare-Prone Periods

Be particularly careful and enlist all your fall-prevention strategies when your MS symptoms are worse. For instance, you may fall more often when you get hot, a common symptom trigger for people with MS. Or perhaps you lose your balance more frequently when you flare or are in a period between disease-modifying treatments, when their effectiveness wanes.

These are times you should be especially vigilant. For instance, if you have a cane but keep it in the closet, take it with you when heading out in the heat if hot weather triggers your symptoms.

It’s always better to take precautions and prevent falls than to react after one happens, so work with your neurology team to find risk mitigation strategies that fit in with your daily activities and are most helpful for you.

Talk With Others Who Understand

MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 198,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you fallen because of living with MS? What interventions do you use to prevent falls? Share your experience in the comments below, or start a conversation by posting on your Activities page.