Spinal Stenosis Care Without Surgery in St. Thomas, U.S. Virgin Islands

Tradewinds Chiropractic & Wellness sees patients with spinal stenosis in Charlotte Amalie, St. Thomas. Dr. Bradley Keys, Doctor of Chiropractic, works with residents, boat and charter crew and visitors at the VI Medical Foundation Building in Estate Thomas, a short drive from Havensight and Yacht Haven Grande. This page explains what stenosis is, what conservative care can and cannot do for it, and when a surgeon needs to be involved.

What spinal stenosis feels like

The usual story is a person past 55 whose legs give out with walking. Not pain so much as heaviness. You start down the Charlotte Amalie waterfront and after a couple hundred yards your legs feel thick and tired, your calves or thighs go numb, and you have to stop. Sit on a bench for a minute and it fades. Walk again and it comes back at about the same distance.

Pushing a shopping cart lets people walk much farther, because they are leaning forward. Standing in line at the ferry dock is not. That pattern, worse with standing and walking upright and better with sitting or bending forward, is called neurogenic claudication. It is the hallmark of lumbar spinal stenosis.

What is usually going on

Stenosis means narrowing. The spinal canal and the nerve root openings get tighter over the years from thickened ligaments, enlarged facet joints, bulging discs and bone spurs. It is the wear process described on our degenerative disc disease page. When you stand tall or arch back, the canal narrows and the nerves get crowded. When you bend forward, it opens and the nerves get room. That is why the shopping cart helps.

Stenosis can also involve the neck. Cervical stenosis may cause neck pain and numb arms, but the worrying version presses on the spinal cord itself. Clumsy hands, trouble with buttons, a change in how you walk, or any bowel or bladder change with a stiff neck needs prompt evaluation by a neurosurgeon or neurologist, not a chiropractic visit.

One-sided leg pain that travels below the knee and is worse with sitting is more often sciatica from a disc. Back pain with no leg symptoms is covered on our lower back pain page.

How we treat spinal stenosis at Tradewinds

Care for stenosis is built around flexion, bending forward, because that position gives the nerves space. On the first visit we take a history, test strength, sensation and reflexes in the legs, watch you walk, and look at any imaging you already have. We take digital x-rays on site when they will change the plan. If you have an MRI from the mainland, bring it. Our free spinal MRI review is still offered: bring the disc in and Dr. Keys goes over it with you. Medicare patients are not eligible for it.

Treatment usually includes:

• Flexion-distraction. You lie face down on a table that gently flexes and stretches the low back while Dr. Keys applies light pressure over the affected levels. No twisting, no thrust.
• Gentle adjusting of the hips, pelvis and stiff segments above the stenosis, with Diversified or drop table methods.
• Flexion-based exercise. Knee-to-chest, pelvic tilts, stationary bike work and a progressive walking program with short seated breaks built in. We avoid extension exercises and back bends, which close the canal.
• Soft tissue work for hip flexors and low back muscles tightened from stooping.

The methods are listed on our services page and 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.

We cannot widen a bony canal. What conservative care often can do is calm the irritated nerves and joints, improve how far you can walk before you have to stop, and keep you active without surgery. Many people with stenosis manage that way for years. We set a trial of care with a re-check date and track walking distance as the measure that matters.

When you should see someone else

Some findings call for a neurosurgeon or orthopedic spine surgeon rather than conservative care:

• Weakness in a leg or foot that is getting worse, or a foot that slaps or drags
• Falls, or a new unsteady walk
• Any loss of bowel or bladder control, or numbness in the groin and inner thighs (go to the emergency room)
• Clumsy hands or a change in gait with neck symptoms, which may mean the spinal cord is involved
• Walking distance that has shrunk to a few steps despite a fair trial of care

Injections from a pain management physician sit between conservative care and surgery, and we refer for them when they fit. We would rather send you to a surgeon than keep you coming in for something that is not moving.

Visitors and crew

Visitors with known stenosis who flare after a long cruise-day walk or a day standing at the rail on a charter can usually be seen the same week. We can get you comfortable enough to finish the trip and send notes to your provider. See hurt your back on vacation.

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

Is there non-surgical treatment for spinal stenosis in St. Thomas?

Yes. Tradewinds Chiropractic & Wellness in Estate Thomas treats lumbar spinal stenosis with flexion-distraction, gentle adjusting, flexion-based exercise and a walking program. The goal is to calm the nerves and improve how far you can walk. We refer to a spine surgeon or pain management physician when the exam calls for it. Call (340) 690-4994.

Do chiropractors treat spinal stenosis in the USVI?

Dr. Bradley Keys at Tradewinds Chiropractic sees stenosis patients regularly. Care avoids extension and thrusting into the narrowed area and leans on flexion-distraction, which opens the canal, plus exercise and soft tissue work. We review your existing MRI or x-rays and tell you plainly whether conservative care is a reasonable trial for your case.

My legs get heavy when I walk and feel better when I sit. What is it?

That pattern is called neurogenic claudication and it is the classic sign of lumbar spinal stenosis, a narrowing of the canal the nerves run through. Leaning on a shopping cart or sitting opens the canal and the legs recover. Poor circulation can cause a similar pattern, so the exam checks pulses in the feet too. An exam and sometimes an MRI confirm it.

Can chiropractic make spinal stenosis worse?

Forceful extension or heavy twisting can aggravate a narrowed canal, so we do not do that. Flexion-distraction and light adjusting of the hips and pelvis are gentle and well tolerated by most older spines. If you have progressive weakness, falls, or bowel or bladder changes, you need a surgeon first, and we will say so at the first visit.

When does spinal stenosis need surgery?

Progressive leg weakness, falls, any bowel or bladder change, signs of spinal cord involvement in the neck, or walking distance that keeps shrinking despite a fair trial of conservative care are the usual reasons. Many people manage stenosis without surgery for years. When it is time, we help you get to a neurosurgeon or orthopedic spine surgeon.