Osteoarthritic changes often occur in the C1-2 or atlanto-axial joint. These changes are a frequent cause of upper neck pain, stiffness and cervicogenic headaches. To diagnose C1-2 joint pain, we inject a local anaesthetic and steroid medication into the joint, under x-ray guidance. If they provide pain relief even for just a few hours, this may signify that your C1-2 or atlanto-axial joints are the root of your pain.