The patient was 34 years old, female, found breast mass one year ago, after radical mastectomy for breast cancer, neck and back pain appeared, after repeated acupuncture, massage, cupping treatment, the pain was still unbearable, and had affected normal life. Initial diagnosis: the patient recognized the pain, complained that he could no longer tolerate the back pain, and the traditional treatment methods could no longer relieve the pain, so he went to the pain clinic to try the treatment. Examination: the patient’s left and right neck activities were limited, the posterior trapezius muscle and trapezius muscle were tight and painful, the cervical 5/6 sphenoidal prominence had compression pain, and the pain of lowering the head was obvious, and the muscles of scapularis muscle were tense and had compression pain. Initial consideration, cervical small joint syndrome, at the same time the patient’s anxiety is obvious. Treatment plan: cervical small joint block therapy (unilateral) + contralateral stellate ganglion block; amitriptyline 12.5mg at bedtime. Second consultation: the patient had a smile on his face, the pain in the left shoulder and back was obviously relieved, and there was still obvious pain when he turned his head to the right, and his sleep was improved. The initial diagnosis was considered correct, and the patient was treated with cervical small joint block (unilateral) + contralateral stellate ganglion block, and amitriptyline was increased to 25mg at bedtime. Third diagnosis: the patient’s pain symptoms have significantly improved, sleep quality can be, continue the former treatment program, unilateral stellate ganglion block, amitriptyline continue to take. The patient was advised to continue to follow the symptoms. Cervical small joint syndrome, mostly due to mild sprain of the neck, so that the synovial membrane embedded in the small joints between the small joints, resulting in small joint interlocking or subluxation, so that the spinal activity is limited. More severe pain occurs. Patients tend to be emotionally tense, have muscle tension, and are afraid to move for fear of being touched or moved by others. Any movement of the spine, coughing, or vibration will aggravate the pain. Some patients may experience dizziness, blurred vision, nystagmus, facial numbness and other head and neck syndromes. One side of the spinous process of the cervical vertebrae is bulging or distorted, and there are pressure points next to the vertebrae. Mostly occur in patients with a history of strain from long-term low head work, or a history of trauma with excessive forward flexion and excessive twisting of the neck. Nerve block therapy or small joint injection has both a diagnostic role, and at the same time can play a therapeutic role in relieving pain, relieving local muscle spasm, etc., and is an effective means of relieving pain, whether it be in the acute exacerbation period or the chronic period.