Actually, I didn't know precisely what level was giving me fits at first. To make an extremely long story short suffice to say that the upper levels of the cervical spine; C3/C4 and higher usually refer pain upwards. I had and still have facet issues. But usually diagnostic injections ruled in or out the various levels. Having said all that, everyone is wired differently. I had one NS tell me that that the C3/C4 should refer pain to my arms and it never did. Fast forward and I found a spinal PM whose speciality was Cervicogenic headaches. For whatever the reason the first group either never hit on the right level or the injection didn't work. But when my second PM, the one I have now, gave me facet and with time, selective nerve root injections at the C3/C4...it was immediate relief which lasted quite awhile. But as he said, the nerve roots were so compressed with OA the pain would always come back. He forwarded me to the NS who quite honestly was aghast. He said too much pain for far too long and fusion it was. The C3/C4 is a very serious level considering the phrenic nerve. I can't remember if there was a herniation or not but the bottom line was...he wanted to stabilize that level. At the same time the C5/C6 was bad but as he said...one level at a time; didn't want to fuse both at once until he saw how well I healed from the first one.
As for the C2/C3, and sorry I got a bit OT, there are facet issues there. I can always tell it is acting up and probably because I have gone through this for 8 years now. But the pain will always be at the base of my skull, I get the bad headaches that won't stop and can feel it in my sternocleidomastoid muscles. Usually when that happens which is actually few and far between now, my PM will give a facet injection on either side. And normally I get anywhere from 6 months to a year's worth of relief. And if I don't get injections I usually try to kick it out with ice, heat and/or meds which sometimes I can. I could opt for an RF but I have declined them since the injections last quite a long while.
Okay, as for the 2nd fusion, you could spot that herniation a mile away!
BUT I had no pain in my arms; just in my thumbs and couldn't hold a pen to write. But I got two years out of it before I had to go forth with a second fusion.
And last but not least my cervical spine is still full of crumbling facets as I call it and a lot of bone spurs. But at least the first fusion I had pretty much got rid of those horrendous headaches and dizziness. As I said, I can still get dizziness or headaches from time to time but not even close to what it used to be. And then again, ON can be muscular in nature. So, yep, it took quite awhile to get an appropriate diagnosis and treatment. The best advice I could give anyone is to find a spinal pain management doctor that really knows this stuff.