### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Could you please help me I am a 52 year old , I am wondering if you could explain why I would feel unsteady on my feet, I do not suffer from dizziness but have this over sense that my balance isn t right. I had an injury but in November where I injured my left foot. But i fell there is something more going on . Just don t have the get up and go anymore

### output:

Hello, I have gone through your query and understand your concern. You have to understand that there are numerous causes for Unsteady gait with loss of balance. It may be neurological, vascular, metabolic, orthopedic or a degenerative change due to aging. It is difficult to find out the exact cause without proper history, examination and further investigation. First we have to rule whether it is due to your injury in left foot and we will look for any asymmetry in lower limb or any form of arthritis in lower limb. Then a thorough neurological examination with gait changes is needed to rule out any parkinsonism, cerebellar lesions like tumors, cord compression, stroke, Multiple sclerosis etc. Next we have to rule out any cardiovascular causes like Arrhythmias which may lead to stroke by examination of pulse, Pulse rate, rhythm, volume and presence or absence of carotid bruits, murmurs etc. Then comes metabolic causes like diabetes(Diabetic neuropathy) or thyroid disorders. After thorough examination and complete history, we recommend investigations based on the findings with salient positive and negative points in history. Some common investigations are routine blood test including CBC, Electrocardiogram, Echocardiogram, X-rays, CT or MRI scan. The treatment depending upon the underlying cause. Hope this helps. Please write back for further queries. Wishing you good health.