@dablues I would recommend getting copies of your MRI disc and taking it to another doctor for a second opinion and you can go into an emergency room with that if you need to. They should have specialists on call.

There is a big concern with doing any physical therapy and manipulation of the cervical spine if there is any spine instability. That needs to be determined by a doctor and may need X rays in different positions so the doctor can measure if the vertebrae are slipping past each other. My physical therapist told me she waits before doing therapy until it is known if there is spinal instability. The blood supply to the brain in the vertebral artery is close to the spine and can be easily injured by a spinal injury. Double vision can have a vascular cause.

I had cervical spinal stenosis with compression of my spinal cord due to a collapsed disc and bone spurs that were compressing it, and I had successful surgery at Mayo to free my spinal cord and a fusion of C5/C6. Is that something that you are considering? You might want to see a spine neurosurgeon for that opinion. The spine surgeon would order necessary tests and is the doctor who can surgically repair a spine problem. A neurologist is the doctor who figures out what nerves are affected and how well they are working. Spine surgeons usually have other specialists they like to work with for these tests, so it might save time and effort if you start with a surgeon. It can be a physical issue because of a spine problem that also causes a vascular issue. I also have thoracic outlet syndrome which is a vascular problem where the physical tightness of my neck and chest muscles compress nerves and blood vessels that go to my arms and this had overlapping symptoms with my spine problem. The best place to evaluate this kind of problem would be at a larger teaching hospital medical center like Mayo or Cleveland Clinic or a major university with a medical school.

You will need to advocate for yourself and not wait a month for an appointment if you feel your case is urgent. Stenosis can cause permanent nerve or spinal cord damage if it goes untreated too long. It took me 2 years to find a surgeon who was willing to help me (before I came to Mayo) and during that time I lost about half my muscle mass in my shoulders and arms. I am 3 years post op now, and still do not have all of my muscle back (perhaps about 2/3). I am still hopeful and still working on it, but it takes along time to recover. You will have to live with the outcome of your decision, so don't waste time on doctors if they don't want to help you. Move on, and find a better one. I wish I had come to Mayo sooner. 5 surgeons prior to this misunderstood my case and would not help me and I just got worse. My Mayo surgeon understood what the problem was and offered to help me right away and I didn't waste 6 months waiting for a series of tests like I had done with the previous doctor only to have him decide to refuse surgery. They are taking a risk with their reputation and ratings of surgical success, and if you are the patient with a few complictaoing issues, it is harder to find a surgeon confident enough to help, so if that is you, start at the top and go to the best who are available to you. Mayo gives priority according to medical need in granting appointments. Hopefully you can request an "emergency" appointment somewhere. Doctors do save slots for emergencies and you can ask for that.