Billy Joel’s love for the stage was also likely what lead to his brain disorder and subsequent surgery.

The “Uptown Girl” singer revealed his normal pressure hydrocephalus (NPH) diagnosis in May 2025. NPH affects his vision, hearing and balance, according to a statement Joel released on social media at the time.

Joel, 77, delved more into his recovery process during a recent appearance on his self-titled SiriusXM show, “The Billy Joel Channel,” and said doctors told him that his rock ‘n’ roll lifestyle caused damage to his brain nerves.

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“I noticed that my balance was not good. I had this sense of being on a boat, like this rocking motion,” Joel said of noticing initial issues. “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 admitted NPH “could be progressive” and get worse, and encouraged Joel to undergo surgery.

Joel remembered his medical team saying, “Well, we drill a hole through your skull and we stick a shunt inside your brain.”

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“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,” he noted. “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.”

Billy Joel previously postponed a string of concerts due to an unknown medical issue. (Getty Images)

“My memory got better, my balance got a little better, my ability to function was better, and I realized, 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.”

He added, “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.”

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Additionally, doctors didn’t want the Piano Man to “stress too much,” so he also began physical therapy while not 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.”

In May 2025, the legendary singer announced that he had been diagnosed with normal pressure hydrocephalus (NPH). (Myrna Suarez)

Joel added, “I just want people to know, don’t worry about me. I’m not going anywhere. I’m here. I’m still here.”

At the time of the announcement, Joel was forced to cancel a number of shows and said that his condition had been “exacerbated by recent concert performances, leading to problems with hearing, vision and balance.”

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“Under his doctor’s instructions, Billy is undergoing specific physical therapy and has been advised to refrain from performing during this recovery period,” his team said in a statement. “Billy is thankful for the excellent care he is receiving and is fully committed to prioritizing his health.”

NPH is a condition that happens when cerebrospinal fluid builds up inside the skull and presses on the brain. This condition is most likely to occur in people over age 65. Treating this condition involves surgery to implant a shunt to drain excess fluid from the inside of the skull, according to the Cleveland Clinic.

During an appearance on Bill Maher’s “Club Random” podcast last year, Joel said his balance has been most affected by the diagnosis.

“I feel fine. My balance sucks. It’s like being a boat,” he told the former stand-up comedian. He noted that doctors have little understanding of the cause of NPH.

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“They don’t know … I thought it must be from drinking,” he told Maher. “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.”

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The “We Didn’t Star the Fire” musician married his fourth wife, Alexis Roderick, during a surprise wedding on July 4, 2015. The couple has two daughters together.