With the progress of society and changes in lifestyle, more and more people are suffering from neck and shoulder pain. There are many causes of neck and shoulder pain, and today we are going to learn about one of the more common ones: cervical small joint syndrome. The cervical spine consists of seven vertebrae, which are connected by intervertebral discs, synovial joints (small joints), and hook and cone joints. The synovial joints have the greatest range of motion during daily tasks such as lowering and turning the head, making them susceptible to degeneration or inflammation and symptoms. Cervical small joint syndrome manifests as pain in the neck, head, shoulders, and upper extremities. It is a dull, poorly localized pain that can be unilateral or bilateral, and can be triggered and exacerbated by cervical flexion, extension, and lateral flexion. The reason for the imprecise localization of pain in the small joint syndrome is that each small joint receives innervation from both the upper and lower segments of the cervical nerve. Depending on the segment involved, there is a range of pain distribution: C12 small joint involvement, with pain located in the occipital region; C23 small joint involvement, with pain extending to the forehead and eyes; C34 small joint involvement, with pain located in the inferior occipital region and posterior-lateral aspect of the neck; C45 small joint involvement, with pain located in the inferior cervical region; C56 small joint involvement, with pain located in the shoulder and medial aspect of the shoulder blade; and C67 small joint involvement, with pain located in the supraspinatus, infraspinatus, and infraspinatus muscles. located in the supraspinatus and infraspinatus muscles. MRI of the cervical spine is recommended for all patients with suspected cervical small joint syndrome to clarify the cause and rule out other serious conditions. To definitively diagnose whether the pain is coming from the small joints, diagnostic treatment can be performed with small joint injections. Treatment of cervical small joint syndrome requires a combination of therapies working in tandem with each other. Mild cases can be relieved by physical therapy such as hot compresses, massage, and nonsteroidal analgesics. If these conservative treatments are ineffective, injections of local anesthetics and hormones into the posterior medial branch of the cervical nerve are feasible and have a definite effect. Radiofrequency ablation of the posterior branch of the cervical nerve can be performed for patients whose injections are effective but have a short maintenance time. Tricyclic antidepressants are effective in relieving pain-related sleep disorders and mood abnormalities.