The bones of the spine are connected by facet joints. Each facet joint is no larger than a thumbnail and has two medial nerves, located in bony grooves in the spine, which carry the sensation of pain to your brain. When the facet joints become inflamed, soreness, stiffness, and neck pain can result and can be felt from the first level of the cervical spine at the top the lower neck. There can be pain on up-and-down movement of the head, neck stiffness, headaches and shoulder and arm pain as a result of cervical facet disease. Treatment of cervical facet disease can range from conservative measures such as physical therapy and medications to facet injections and medial branch blocks designed to inject local anesthetic and a longer-acting steroid medication into the source of the pain to cervical surgery in extreme cases.