Billy Joel says his years of performing loud rock concerts likely contributed to the brain condition that required him to undergo surgery earlier this year.
The 77-year-old singer, who publicly revealed his diagnosis of normal pressure hydrocephalus (NPH) in May 2025, discussed his recovery in detail during a recent appearance on his SiriusXM show, “The Billy Joel Channel.” NPH is a condition in which cerebrospinal fluid builds up inside the skull and presses on the brain, and it most often occurs in people over 65, according to the Cleveland Clinic. It can affect vision, hearing and balance.
Joel said he first noticed something was wrong through problems with his balance.
“I noticed that my balance was not good. I had this sense of being on a boat, like this rocking motion,” Joel said. “I wasn’t steady on my feet. I didn’t know why that was, and I went to meet with the neurologist, and I was diagnosed with having something called normal pressure hydrocephalus, which they used to call water on the brain.”
Doctors told him the condition could progress and recommended surgery to implant a shunt in his brain to drain the excess fluid.
“Well, we drill a hole through your skull, and we stick a shunt inside your brain,” Joel recalled being told.
He said he was initially reluctant but changed his mind after learning more.
“I didn’t want to do that, but then I read up on it and I realized it can help improve your balance and can help your memory,” Joel said. “You know, I don’t want to lose my marbles. It’s hard to tell what’s age and what’s a condition, so I agreed to do the shunt and I had a surgery. And they implanted a shunt in my brain, and it actually improved things.”
Joel said the surgery brought noticeable improvement.
“My memory got better. My balance got a little better. My ability to function was better,” he said.
He also said doctors linked his condition directly to the physical toll of performing rock music at high volume for decades.
“And the doctors told me this, because of my job, which is playing rock and roll music very loud, that it was giving me something like a concussion every time I did a show. It was causing damage to my brain nerves, and I could be losing more brain cells the more shows I did. And I realized that means I shouldn’t be doing this right now. I got to improve.”
Doctors also advised Joel to avoid excessive stress, and he began physical therapy while stepping away from performing.
“I’m doing whatever it is they tell me to do because I don’t want to lose it, you know? So, I’m always testing myself,” Joel said. “I know people have heard, ‘Oh, he’s got a brain disorder,’ and I’m OK.”
He added a message for concerned fans: “I just want people to know, don’t worry about me. I’m not going anywhere. I’m here. I’m still here.”
When Joel first announced the diagnosis, he canceled a number of scheduled shows, saying his condition had been “exacerbated by recent concert performances, leading to problems with hearing, vision and balance.” His team said at the time that he was “undergoing specific physical therapy and has been advised to refrain from performing during this recovery period,” adding that he was “thankful for the excellent care he is receiving and is fully committed to prioritizing his health.”
During an appearance on Bill Maher’s “Club Random” podcast last year, Joel said his balance remained the most noticeable effect of the diagnosis and that even doctors don’t fully understand what causes NPH.
“I feel fine. My balance sucks. It’s like being a boat,” Joel told Maher. “They don’t know. … I thought it must be from drinking. I feel good. They keep referring to what I have as a brain disorder, so it sounds a lot worse than what I’m feeling.”
Joel married his fourth wife, Alexis Roderick, in a surprise wedding on July 4, 2015. The couple has two daughters together.
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