Back pain often feels huge. It feels complicated, and for a lot of our clients, it actually runs their life. But here’s the truth. Pain is often a mile wide, but only an inch deep. And sometimes that inch is found in the oculomotor system. Now that, what is that? That’s the brain’s control of eye movements.
Now that may sound crazy, it may sound a little bit weird, but we’re gonna talk about the research behind this, and show you what to do with it because whenever we start to really evaluate people with low back pain, it quickly becomes evident that sometimes a solution is not found in doing mobilization in the low back, doing more motor control exercises, doing a lot of soft tissue.
It is instead found in looking at systems that control what the low back’s going to do when we’re moving through the world. Now, if this sounds interesting to you, you are a movement professional and you’re interested in learning more about how we evaluate the eyes, how we evaluate the inner ear, and how that takes a primary role often in dealing with our common aches and pains and people that, uh, people complain about when they come to see us. Make sure to go to the pinned comment, DM us on Instagram or send us an email because we’d love to share with you more information about our curriculum.
Having said that, let’s talk about the eyes and what research is currently showing us about low back pain and oculomotor dysfunction, ocular eye motor movement.
Whenever we look at the eyes, there are a few different movements that we are always evaluating. One is called smooth pursuit. Smooth pursuit means that I have something, um, my head is still, and I’m tracking an object as it moves across my field of vision. Another oculomotor activity is called a saccade. Where I have an object over here, I’m looking at it, and then I quickly shift my focus to the one over here. So here. If this one moves and I shift, and again, most of this is done without moving the head very much. Now in real life, this hopefully makes sense. I’m walking along, um, by the road, I see a car coming and I’m watching it. That may be smooth pursuit, but then if it’s really fast, then I have to saccade.
If I am reading my eyes have to do another ocular motor, uh, activity, which is converge. So my eyes move in and then I look in the distance, my eyes have to diverge. So whenever we talk about oculomotor dysfunction, we’re typically talking about a problem with smooth pursuits or saccades or convergence and divergence.
All right, now, whenever we look at the research literature, here’s what we’re seeing. People with chronic low back pain when tested typically show dysfunction in smooth pursuits. They often show also dysfunction in saccades. Now there hasn’t been as much research, uh, that we’ve been able to find on convergence and divergence, but experientially, uh, we see this a lot as well.
So the reason this is problematic is that as we’re moving through the world, our eyes are constantly telling us about our environment, and when our eyes move slowly, they move inefficiently or they move inappropriately. Your body is what paves the price. Right. Think about this. Uh, last time you got up in the middle of the night, uh, I didn’t wanna turn any lamps on and, and it was in a hotel place you’ve never been before.
Did you just walk, get outta bed and walk confidently to the bathroom? Or did you kind of move slowly? It changed your gait. You actually would’ve created more tension to protect yourself. Whenever we lose visual competency. The brain goes into a protective mode, and often that protective mode involves increasing tension in the low back, increasing tension in the core.
and this is what we tend to see in people with chronic low back pain. So whenever we connect the dots here, what this tells us is that every person with low back pain should have their oculomotor system assessed. This is something, again, we teach throughout our curriculum because it is so essential and so necessary because a lot of people with chronicle back pain, you can again mobilize and do exercises and strengthen and adjust and mo manipulate and brace all day. But if the visual system, which is what is in charge of helping us get through our day safely is dysfunctional, there is going to be ongoing adaptation in the rest of the body. And for people with chronic low back pain, unfortunately that adaptation tends to be tension in the low back. And that eventually can create this cycle where the brain’s like, eh, the low back’s not moving safely.Uh, my eyes aren’t telling me what’s going on, so I need to have some pain because I need you to not move around as much. That’s the basic explanation of how all this works.
So what do you do about this? Again, if you’re a movement professional and you’re dealing with people with back pain, particularly chronic low back pain, start off with smooth pursuit testing, right?
You’re just gonna use your finger or use an object, a pen or something. You’re gonna have them hold their head still and have them follow the target. Do it in multiple directions. What you’re looking for is a slow uncoordinated movement. Now, how that may uh, show up is as you begin moving your finger, their eyes jump in front and wait for the finger to catch up.
Their eyes may fall behind and then they do a quick saccade to catch up. It may be that their eyes just look unsteady. They’re just bouncing the entire time. If you see any of those things, those are pretty clear indication that their oculomotor system is dysfunctional. And what you can then do is have them stand, put your hand on their low back, get a general idea of how tense they are, and then begin testing their eye movements.
What you will typically see is as you increase demand on their eyes, you will feel more and more tension developing in their low back. Now it becomes a matter of, all right, what do I do next? Well, now you have to train their eyes. Uh, so if you aren’t sure how to do that again, you can contact us. You can go through our blogs, check out, uh, Instagram as well. We have tons of free information about this. Um, on top of that, obviously, as I said, we have an entire educational curriculum where we go into this in great depth.
So big takeaway here is if you have people with low back pain, you must assess their oculomotor system. You need to look at smooth pursuits, you need to look at saccades.
You need to look at convergence, divergence, and it may be that their pains feels huge and it may feel complicated, but the solution may be as simple as initiating some basic oculomotor training and including that in part of the, uh, process that you’re going through with ’em. All right, uh, hope you enjoyed this.
Hope you found it really useful. If you enjoy this kind of information, subscribe to the channel. And again, if you are a movement professional interested in bringing brain-based training into what you do, make sure to go to the pinned comment. DM us on Instagram so we can get in contact with you or drop us an email because we’d love to share more.
