Vertigo and Dizziness Care in St. Thomas, U.S. Virgin Islands

Dizziness has many causes, and only some of them belong in a chiropractic office. The one we treat is cervicogenic dizziness: unsteadiness that comes from a stiff, sore or injured neck. Dr. Bradley Keys, Doctor of Chiropractic, examines dizzy patients at Tradewinds Chiropractic & Wellness in St. Thomas, treats the neck-related kind, does the Epley maneuver for BPPV, and sends other inner ear, heart and brain causes to the right clinician.

What neck-related dizziness feels like

Less a spinning room than a feeling of being off: lightheaded, floaty, slightly drunk. It comes with neck pain or stiffness, often after a whiplash injury, a long week at a desk, or a bad pillow. Turning the head or holding it in one position for a while brings it on. Headaches at the base of the skull often travel with it.

True vertigo, where the room spins for seconds when you roll over in bed or look up to a top shelf, is usually the inner ear, not the neck. More on that below.

What is usually going on

The upper neck is packed with position sensors. The joints and deep muscles of the top three vertebrae tell the brain where your head is, and the brain matches that against the inner ears and the eyes. When the neck is stiff, guarded or injured, that signal gets noisy, and the mismatch is what you feel as unsteadiness. It is why whiplash patients are so often dizzy for weeks after a crash, and why a bad neck so often comes with headaches.

Other causes need a different door:

• BPPV (benign paroxysmal positional vertigo). Loose crystals in the inner ear. Brief, intense spinning with specific head positions. Treated with a repositioning maneuver that moves the crystals back where they belong. We do the Epley maneuver (canalith repositioning) for BPPV.
• Vestibular neuritis, Meniere's disease and other inner ear problems. Longer spells of spinning, often with hearing change or ringing. An ENT or a vestibular physical therapist.
• Cardiac and blood pressure causes. Lightheadedness on standing, a racing or skipping heartbeat, near-fainting. Your physician or the emergency room.
• Neurological causes, including stroke, migraine and medication side effects. A physician or neurologist.
• Heat and dehydration. Common here and easy to overlook. A day on the water in August can do it on its own.

How we treat it at Tradewinds

The first visit is a careful history (what the dizziness feels like, what triggers it, how long it lasts, hearing changes, medications) and a neurological screen. We examine the upper neck joint by joint, test whether neck movement reproduces your symptoms, and run a simple positional screen for the inner ear pattern. If the screen points to BPPV, Dr. Keys does the Epley maneuver. If the exam points to neither BPPV nor the neck, we say so and refer before treating.

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.

When the neck is the source, care is gentle. Dr. Keys restores motion at the upper cervical joints with a specific adjustment, using drop table or other low-force methods where the exam calls for them, works the small muscles at the base of the skull with instrument assisted soft tissue mobilization, and starts a short rehabilitation program: deep neck muscle activation, then head-and-eye coordination drills that retrain the position sense the neck has lost. These are on our services page, and the neck pain page covers the neck itself in more detail.

Cervicogenic dizziness usually improves in step with the neck, over a few weeks. If the dizziness is not tracking with the neck, we stop and refer rather than keep going.

When you should see someone else

Call 911 or get to the emergency room right away if dizziness comes with any of these:

• Double vision, trouble speaking, or slurred speech
• Weakness or numbness on one side of the body, or a drooping face
• A sudden severe headache, the worst you have had
• Chest pain, shortness of breath, or fainting
• Trouble walking, sudden severe loss of balance, or confusion
• New hearing loss in one ear with the spinning

Those are signs of stroke, heart trouble or an inner ear emergency, not a chiropractic problem.

See your physician first if you are over 60 and the dizziness is new, if you take blood pressure or heart medication, or if you have diabetes. See an ENT or a vestibular therapist for spinning vertigo with hearing change, or for positional vertigo that does not settle after repositioning. We will tell you plainly if you should not have started with us.

Visitors, crew and cruise passengers

A rocking feeling for a day or two after stepping off a boat or a cruise ship is common and fades on its own. If it lasts for weeks, that is a vestibular pattern, not a neck one, and it belongs with a vestibular therapist. Crew whose neck tightened up on a passage, with a woozy head to match, are a different story and we see them regularly. We take walk-ins and same-day appointments.

Getting seen

Tradewinds Chiropractic & Wellness is in the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802, just east of Charlotte Amalie. Hours are 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.

Call (340) 690-4994 or email info@tradewindschiropractic.com. We take walk-ins and same-day appointments. We see patients from St. Thomas, St. John and Water Island and have more than 180 five-star Google reviews. New patient forms are on our website to download and print.

Questions patients ask

Dizziness from my neck, who can help in St. Thomas?

Dr. Bradley Keys at Tradewinds Chiropractic & Wellness in Estate Thomas examines dizzy patients, confirms whether the neck is the source, and treats cervicogenic dizziness with gentle upper neck adjustment, soft tissue work and rehabilitation. If the cause is BPPV, he does the Epley maneuver. If it is another inner ear problem, the heart or the nervous system, he refers you to the right clinician. Call (340) 690-4994.

Is there a chiropractor for vertigo in St. Thomas, USVI?

Tradewinds Chiropractic treats dizziness that comes from the neck. True spinning vertigo is usually an inner ear problem such as BPPV, which needs a repositioning maneuver rather than a spinal adjustment. We do the Epley maneuver (canalith repositioning) for BPPV. We screen for it on the first visit and refer other inner ear problems to an ENT or vestibular therapist.

How do I know if my dizziness is from my neck or my inner ear?

Neck-related dizziness feels like unsteadiness or lightheadedness, comes with neck pain or stiffness, and is brought on by turning or holding the head in one position. Inner ear vertigo is a true spinning sensation, often set off by rolling over in bed or looking up, sometimes with ringing or hearing change. An exam separates the two in most cases.

Can a chiropractor treat vertigo?

A chiropractor can treat dizziness caused by the neck, and that is what we do. We also do the Epley maneuver for BPPV. Vertigo from other inner ear problems, the heart, blood pressure or the brain needs a different clinician, and part of our exam is ruling those out before any treatment starts.

When is dizziness an emergency?

Call 911 if dizziness comes on with double vision, slurred speech, weakness or numbness on one side, a drooping face, a sudden severe headache, chest pain, fainting, or sudden inability to walk. Those are stroke or heart warning signs and they need an emergency room, not a chiropractic office.