| Neck Pain The structures which, if injured or worn out, can cause pain include: muscles, fascia (the tissue covering the muscles), ligaments, discs, bones, joints, and nerves. When the pain is from torn muscles or fascia (the sock covering the muscles), there is usually tenderness to touch in the involved areas. When the pain is from a disc or ligament or joint problem, which are deeper structures, it is usually difficult to reproduce the pain by touching the back of the neck.  To appreciated the types of abnormalities that can be seen on xrays, look first at this cervical spine xray that would be considered normal. Now compare that xray to one with degenerative changes in the xray below. Pictured on this MRI, looking at the spine from a side (sagittal) view of a different patient, the arrows indicate bulging or herniated discs. Here is another example of a herniated disc at the C34 level.  On the cross sectional view, the C3-4 herniated disc can be seen indenting and impinging upon the spinal cord. Since there is not much extra room around the nerves and spinal cord, it would make sense that a small mass next to the nerves and spinal cord can cause significant symptoms. Another example: here is a section through a segment without symptoms. There is a small disc bulge marked by an asterisk, but this bulge is not likely causing problems, as there is no pressure on the spinal cord or an exiting nerve root. 
However, in this other segment on the same patient, there is a large herniation at the level pictured here. This extruded disc material almost blocks the path for the exiting nerve root on the right side, which correlated with the patient's right arm pain and numbness.  Here is the side (sagittal) view. 
| |