What is the connection between back, neck, and eye pain?

How are your eyes, neck, and back connected?

If you have ever experienced eye strain and discomfort at the same time as neck or upper back pain, you may have wondered how these areas are linked. Put simply, muscle tension in your neck and back can't directly cause eye problems and discomfort, and vice versa.

However, having simultaneous complaints of the eye, neck, and/or upper back could indicate that you are participating in certain activities or behaviours that are causing your discomfort in all of these areas.

There are also a few health issues where discomfort in one area may result as a symptom of a problem with the other. In other words, neck and back pain can be symptomatic of an eye problem, and eye discomfort (in the form of headaches around the eye area) can point to neck and back issues.

Activities that cause eye, neck, and back discomfort

Many of the activities that cause eye strain and discomfort also lead to neck and back problems. Eye strain is extremely common and occurs when your eyes become tired from intense use. You may also feel eye discomfort in the form of dry eyes or intermittent slight blurring of vision. These same activities often promote poor posture in your neck and back, which in turn can cause muscle tension and pain in these areas.

Research has shown that many of these activities involve visually demanding near work. Near work is defined as any activity performed at a short working distance. If undertaken for long periods of time, evidence shows this can result in eye strain owing to the need for intense visual attention, and poor posture due to the need or urge for closer proximity (especially when eye strain is disrupting your sight).

Examples of near work include reading, writing, playing video games, and needlework. But there is little doubt that in the 21st Century, the most significant example is digital display use. Digital eye strain, also called computer vision syndrome, is a common cause of both eye discomfort and neck and back pain.

One study analysing the use of electronic readers (e-readers) found significantly higher rates of eye strain and irritation. Exposure to the screen's intense light and smaller font size are two of many factors which are making digital display use a "major public health concern", believed to affect 50% or more of computer users.

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Eye problems

There are several eye problems that may also be indirectly connected with your back and neck pain.

Binocular vision dysfunction

Binocular vision dysfunction (BVD) is a common visual misalignment condition. The eyes struggle to send a clear image to the brain because they are slightly misaligned. There is a vast range of visual and physical symptoms, but the main visual signs include blurred vision, light sensitivity, and eye discomfort when moving.

Shoulder and neck pain are among many other potential physical symptoms of BVD. This is because the visual misalignment causes muscle tension, which is made worse for those who compensate by tilting their heads towards one shoulder. This may help to realign the images vertically, but this is a dangerous habit that can lead to ongoing neck pain.

Hypermetropia

People with hypermetropia, also known as long-sightedness, can see objects in the distance clearly while objects nearby are out of focus. This makes is difficult for the eye to focus light on to the correct part of the retina.

As a consequence, without correctional lenses long-sighted people tend to strain their eyes in an attempt to improve focus. It's possible that attempting to move closer or further away from the object results in bad posture habits, making the pain worse.

Presbyopia

Presbyopia is age-related long-sightedness. To see objects clearly at different distances, the eye's lens needs flexibility. Naturally with age, this flexibility decreases, and lenses become stiffer. Like hypermetropia, if left untreated this can cause strain in your eyes as well as neck and back pain.

Neck and back muscle tension

Leanne Antoine, chartered physiotherapist and spokesperson for the Chartered Society of Physiotherapy (CSP), advises that muscle tension in your neck and back can also indirectly result in eye pain.

This happens when unconscious tensing of the muscles in the neck, upper back, and shoulders leads to tension in the back of the skull - the occipital area. This can lead to headaches that affect the area around the eye.

Muscle tension in the back and neck could arise for a variety of reasons, and physiotherapists can help to establish the primary cause of your pain and offer a tailored physiotherapy service to relieve the tension.

Cervicogenic headaches

"As physiotherapists it is important that we establish the primary cause of the muscle tension, but if the patient is presenting with eye pain, they may well also have a secondary headache which is called a cervicogenic headache (CGH)," explains Antoine.

"This headache, as the term suggests, originates from the cervical spine (neck) and is characterised by neck pain and stiffness which may well be accompanied by muscle tension."

CGH symptoms usually occur on just one side of the neck, head, and/or face and commonly affect the area around the eye. This headache is usually a moderate, dull ache but can be more intense. In some cases, it can also result in eye swelling and blurred vision.

Antoine adds: "There is also a school of thought that if certain structures in the upper part of the neck are injured or damaged in some way, the sensory input of that damage can create an increased sensitivity, leading to this type of headache."