India is facing a largely overlooked public health crisis, with balance disorders affecting an estimated 25–30 per cent of the population, including nearly 250 million people and over 30 per cent of high school students. Despite the scale of the problem, the country has only 70–80 specialised clinics dedicated to balance and vestibular disorders, leaving millions of patients undiagnosed, misdiagnosed, or inadequately treated.

Vertigo alone affects about 40 per cent of adults and accounts for more than half of all dizziness-related cases. It is responsible for nearly 5–10 per cent of primary care visits and almost 30 per cent of consultations in neurology and ENT departments. The burden increases sharply with age, with prevalence rising to 30 per cent among those over 60 years, 35 per cent in those over 70, and nearly 50 per cent in individuals above 80.

Highlighting the severity of the situation, Dr Anirban Biswas, one of India’s leading experts in neurotology and balance disorders, described the current state of vertigo care as a systemic failure. Speaking during his keynote address at the HEAL OneHealth Connect Series organised by Pacific OneHealth at the India Habitat Centre, Dr Biswas said most patients consult between four and seven specialists before receiving any clarity.

“They undergo expensive scans that are often irrelevant to their condition and are eventually prescribed symptom-suppressing drugs rather than given a diagnosis or cure. This is not patient care as it should be,” he said.

Balance disorders, experts explain, are complex conditions involving not only the inner ear but also neurological, cardiovascular, psychological and musculoskeletal systems. However, India’s healthcare system lacks structured training in neurotology, and multidisciplinary balance clinics remain rare.

As a result, patients are frequently subjected to repeated MRI scans, CT scans and blood tests, while essential evaluations of cognition, proprioception and functional balance are neglected.

Dr Biswas pointed out that only around 27 per cent of patients presenting with vertigo actually have inner-ear pathology, yet most diagnostic efforts continue to focus exclusively on the vestibular labyrinth. “This narrow approach explains why patients remain symptomatic for years and why there is a widespread belief that vertigo cannot be cured,” he noted.

The impact of untreated balance disorders extends beyond physical symptoms. Studies have linked them to anxiety, depression, cognitive impairment and a persistent fear of falling, significantly diminishing quality of life. With India’s rapidly ageing population and a large working-age demographic already affected, specialists warn that balance disorders represent a silent but serious public health challenge.

Medical experts are now calling for policy recognition of balance disorders as a multidisciplinary condition, along with the establishment of dedicated balance and vestibular clinics and improved training for healthcare professionals. They caution that failure to invest in specialised vestibular infrastructure could expose India’s elderly population to a rise in fall-related injuries and dementia.

Organised by Pacific OneHealth in partnership with the HEAL Foundation, the HEAL OneHealth Connect Series served as a strong call to action for the medical community.

The discussion urged a shift away from generic treatment approaches toward specialised, evidence-based care, reinforcing the vision of “Healthcare As It Should Be” to prevent long-term disability and improve patient outcomes across the country.