Sacroiliac (SI) Joint Pain Treatment in St. Thomas, U.S. Virgin Islands

Tradewinds Chiropractic & Wellness treats sacroiliac joint pain in Charlotte Amalie, St. Thomas. Dr. Bradley Keys, Doctor of Chiropractic, sees residents, new mothers, boat and charter crew, cruise passengers and visitors at the VI Medical Foundation Building in Estate Thomas, just east of town. This page covers where the SI joint is, why it hurts, what we do for it, and when the pain needs a physician instead.

What SI joint pain feels like

Put your hands on your hips and slide your thumbs back toward your spine. Just below the belt line on either side there is a small dimple, and the sacroiliac joint sits right under it. SI joint pain is a deep ache at that dimple, almost always on one side, spreading into the buttock and sometimes the back of the thigh. It rarely goes below the knee.

It is worse rolling over in bed, getting out of the car, standing on one leg to pull on shorts, and going up stairs. Many people point straight at the spot with one finger, which is a useful clue, since disc pain is harder to localize.

Two groups show up with it often. New mothers, because the ligaments around the pelvis loosen during pregnancy and the joint stays unsettled for months after delivery. And people who fell hard on one hip or the tailbone, off a boat deck or down wet stairs, and have had a one-sided ache since.

What is usually going on

The SI joints connect the sacrum, the wedge of bone at the base of the spine, to the two halves of the pelvis. They move very little but carry all the load passing between the spine and the legs. When one gets stuck, or moves too much because the ligaments are lax, the joint gets irritated and the glutes and piriformis tighten to guard it.

A leg length difference, standing on one hip, one-sided lifting and the hormonal changes of pregnancy all set it up. SI pain gets lumped in with general lower back pain and overlaps with piriformis syndrome and hip pain, which is why the exam matters.

How we treat SI joint pain at Tradewinds

There is no single test for the SI joint, so the exam uses a cluster of provocation tests, each loading the joint a different way: pressing down on the front of the pelvis while you lie on your back, squeezing the pelvis from the side, pushing the thigh back through the hip, and pulling the knee across the body. When most of them reproduce your pain at the dimple and the disc and nerve tests are negative, the SI joint is the likely source. We take digital x-rays when the history calls for it, such as after a fall.

Treatment is hands-on:

• Drop-table adjustment of the pelvis. You lie face down, a section of the table rises under the hip, and a quick light push lets it drop. No twisting, which most people with a tender SI joint prefer.
• Side-posture adjustment, lying on your side, when the joint is stuck and needs a more specific push.
• Soft tissue work for the glutes and piriformis guarding the joint.
• A pelvic belt, worn low around the hips, for a joint that is too loose rather than too stiff, which is common after pregnancy.
• Rehab, mainly glute and deep abdominal strengthening, to hold the correction.

Services are listed on our services page. New mothers can read our pregnancy care page for how we modify the techniques. A first visit is described on what to expect.

Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands.

A stuck SI joint often responds within a handful of visits. A loose one after pregnancy takes longer and depends more on the belt and the rehab than on the adjustment. We set a plan with a re-check date, and if you are not improving on schedule we tell you.

When you should see someone else

Most SI pain is mechanical. A few patterns are not:

• Morning low back and buttock stiffness lasting over an hour, going on for months, easing with activity, in someone under 40. That can be inflammatory, such as ankylosing spondylitis, and needs bloodwork and a rheumatologist.
• Fever with pelvic or low back pain, which can mean an infected joint.
• Numbness or weakness in a leg, numbness in the groin, or any bowel or bladder change. Those point to the spine, not the SI joint, and the last two mean the emergency room.
• Pain after a serious fall that is not settling, where a fracture of the sacrum or pelvis has to be ruled out.

Visitors and crew

Charter crew spend hours braced on one leg on a moving deck, and guests off long flights show up with one-sided SI pain fairly often. We can usually see you the same week. Our boat and charter crew page covers scheduling around a charter.

Getting seen

Tradewinds Chiropractic & Wellness is at the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802. Call (340) 690-4994 or email info@tradewindschiropractic.com.

Hours: Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun.

We take walk-ins and same-day appointments. We have more than 180 five-star Google reviews.

Questions patients ask

Where can I get sacroiliac joint pain treatment in St. Thomas?

Tradewinds Chiropractic & Wellness at the VI Medical Foundation Building in Estate Thomas treats SI joint pain with drop-table and side-posture adjustment, soft tissue work, a pelvic belt where the joint is loose, and rehab. Dr. Bradley Keys examines the joint with a cluster of provocation tests before treating it. Call (340) 690-4994.

I have one-sided low back pain near the dimple. Can a chiropractor in the USVI help?

A one-sided ache right at the dimple above the buttock, worse rolling in bed and standing on one leg, is the typical SI joint picture, and it usually responds well to chiropractic care. We confirm it on exam, rule out the disc and the hip, and treat the joint directly. Most stuck SI joints improve within a handful of visits.

Is SI joint pain after pregnancy normal, and can it be treated in the Virgin Islands?

It is common. Pregnancy loosens the pelvic ligaments and the joint can stay unsettled for months after delivery. We treat it at Tradewinds with gentle adjustment, a pelvic belt worn low on the hips, and glute and core rehab to stabilize the joint as the ligaments tighten. See our pregnancy care page for how soon after delivery we see patients.

How do you know it is the SI joint and not a disc?

The exam. SI pain points to one spot at the dimple, stays above the knee, and is reproduced by tests that load the joint. Disc pain is harder to pinpoint, often travels below the knee, and shows up on nerve tension and reflex testing. When the picture is mixed we may x-ray or refer for an MRI.

Does an SI joint adjustment hurt?

Usually not. The drop-table method is a quick, light push with the table doing most of the work, and there is no twisting. Side-posture adjusting is a little more involved but over in a second. Some soreness the next day is normal after the first visit or two.