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.

Muscle tension in your neck and back can't directly cause eye problems and discomfort - or the other way around. However, having eye and back pain together could be a sign that certain activities or actions are causing your discomfort in all of these areas.

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

Activities that cause neck, eye and back pain

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 having vision that goes slightly blurry every so often. These same activities often promote poor posture in your neck and back, which in turn can cause muscle tension and pain in these areas.

Many of these activities involve visually demanding near work - which means any activity performed at a short working distance¹. Examples of near work include:

• Reading.

• Writing.

• Playing video games.

• Needlework.

But there is little doubt that in modern life, the most significant example is digital display use - when we stare at our mobile, laptop, or ipad screens. Digital eye strain, also called computer vision syndrome, is a common cause of both eye and back pain.

Long periods of close-up work can result in eye strain, because it involves us staring intensely and positioning ourselves near to the screen/book/paper/needlework - which leads to poor posture².

Patient picks for Other eye problems

Eye health

Anatomy of the eye

When you look at an object you see it because light reflects off the object and enters your eye. Your eye focuses this light into an image on the layer of the eye called the retina.

by Dr Mary Elisabeth Lowth, FRCGP

Eye health

Uveitis

Uveitis is a general term describing inflammation of the part of the eye called the uveal tract. This consists of the iris, ciliary body and choroid - although uveitis can additionally involve other parts of the eye. It can be caused by diseases or problems of the eye alone, or can be a part of conditions affecting other parts of the body. Uveitis is classified according to exactly where in the uvea it occurs, and symptoms also vary with the affected area. Treatment, often with pupil dilators and steroid eye drops, can usually reduce inflammation and ease symptoms. However, the treatment itself can cause complications. If treatment is not started promptly and/or complications occur, uveitis can lead to permanent loss of vision.

by Dr Laurence Knott

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 are many symptoms, but the main visual signs include blurred vision, light sensitivity, and eye discomfort when moving.

BVD can also cause shoulder and neck pain. This is because the visual misalignment causes muscle tension, which is made worse for people 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.

Long sightedness

If you are long-sighted (hypermetropia) you can see objects in the distance clearly while objects nearby are out of focus. This makes it difficult for the eye to focus light on to the correct part of the retina.

As a result, without prescription eyeglasses or contact 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 both eye and back pain.

Neck and back muscle tension

Leanne Antoine, 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 you unconsciously tense the muscles in your neck, upper back, and shoulders. This leads to tension in the back of the skull - the occipital area - causing headaches that affect the area around your eye.

Muscle tension in the back and neck can be triggered by many things. Physiotherapists can help you find the 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 your muscle tension. But, if you have eye pain, you may also have a secondary headache which is called a cervicogenic headache (CGH)," explains Antoine.

"This headache starts in the cervical spine - your 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 your 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, that damage can create more sensitivity, leading to this type of headache."

Further reading

1. Zetterberg et al: Neck/shoulder discomfort due to visually demanding experimental near work is influenced by previous neck pain, task duration, astigmatism, internal eye discomfort and accommodation.

2. Zetterberg et al: Trapezius muscle activity increases during near work activity regardless of accommodation/vergence demand level.

3. Maducdoc et al: Visual consequences of electronic reader use: a pilot study.

4. Coles-Brennan et al: Management of digital eye strain.

5. Randolph: Computer vision syndrome.