Dr David Vivian

Dr. David Vivian

Musculoskeletal Physician
MBBS FAFMM GDMM MM (Pain Medicine)

Dr David Vivian is past-president and a Fellow of the Australasian Faculty of Musculoskeletal Medicine (AFMM). He has over 30 years’ experience in pain assessment & management of complex musculoskeletal problems. He is a director of Metro Spinal Clinics, and has a vast experience not only in the diagnosis and management of complex pain problems, but also in specific pain interventions including spinal and peripheral nerve stimulation, spinal·radiofrequency neurotomy·and epidural injection. ·He has recently authored medical text-book chapters on spinal pain pathophysiology, discography, internal disc disruption, radicular pain, sacro-iliac joint assessment and intervention, interventional disc treatment and the role of diagnostic imaging in discogenic pain, and sub-edited a section on Spinal Pain and Intervention in the medical textbook, Pain Procedures in Clinical Practice. ·He has also written national guidelines for spinal pain and anterior knee pain. As Chairman of the Board of Clinical Intelligence, he is active in innovative data collection and research. Examples of the research efforts in which he is involved in within Metro Pain Clinics includes published articles in Neuromodulation, Pain Medicine and Spine in the last few years, and involvement in various prospective clinical trials.

Qualifications

Bachelor of Medicine and Surgery (MBBS)
- University of Melbourne, 1976
Graduate Diploma Musculoskeletal Medicine (GDMM)
- Flinders University, 1994
Fellowship Australasian Faculty Musculoskeletal Medicine, 1999 (FAFMM)
Master of Medicine (Pain Management)
- Sydney University, 1999

Additional post-graduate education

Diploma in Orthopaedic Medicine in London, 1980
Course in physical medicine at the Coppleston Postgraduate Medical Institute, Sydney University, 1981
Completed requirements for the Licentiate in Musculoskeletal Medicine of the Australian Association of Musculoskeletal Medicine, 1981
Accredited as a Master of Spinal Needle Techniques, by objective examination, under the auspices of the International Spinal Injection Society (ISIS), 1998.

Over many years, Dr Vivian has attended numerous cadaver course in needle intervention; combined use of anatomical dissection with placement of needles under fluoroscopic vision.

Clinical and other medical experience

1979-1980: Orthopaedic medicine, in London
1981-present: Musculoskeletal medicine referral practice
1982 - 2005: Senior Partner, Brighton Spinal & Sports Medicine Clinic
1987 - 2004: Co-director, Brighton Pain Management Program
1988 - present: Senior Partner, Metro Spinal Clinic (formerly Metropolitan Spinal Clinic)
1997 - 2004: Director, Metropolitan Spinal Rehabilitation Program
1997 – 2002: Musculoskeletal Medical Officer, for the National Musculoskeletal Health Initiative
1998-2002: Member of Victorian Medical Workcare Panels in the discipline of Musculoskeletal Medicine
1999-2001: Faculty, Master of Medicine, Pain Management, University of Sydney
2001: Faculty, Master of Medicine, Pain Management, University of Newcastle
1999-2002: Consultant, Barbara Walker Centre for Pain Management, St. Vincent ’s Hospital, Melbourne
2011-present: Director Metro Pain Clinics
2012-present: Chairman of Board of Clinical Intelligence
2012-present: Board director of Ekera Medical

Elected and other delegated positions

Committee, Australian Association Musculoskeletal Medicine, 1983-1995
Secretary, Australian Association Musculoskeletal Medicine, 1985-1988
President, Australian Association Musculoskeletal Medicine, 1988-1991
Vice-President, Australian Association Musculoskeletal Medicine, 1991-1993
Treasurer, Australasian Faculty Musculoskeletal Medicine, 1997-2003.
Vice-President, Australian Faculty Musculoskeletal Medicine, 2003- 2005
President, Australasian Faculty Musculoskeletal Medicine, 2005-7.
ISIS Research Committee 2011- . http://www.spinalinjection.org/index.php?option=com_content&view=article&id=62&Itemid=68

Research experience

Precision injection of the shoulder joint in clinical practice, 1998-2005
Accuracy of epidural injections – a self-audit and practice-audit, 2003 – 2008
Incidence of intra-vascular injection in medial branch blocks and epidural infiltration, 2003- 2008
Radiation exposure in spinal needle intervention, 2002 – present
Shoulder pain; 2008 - present
Co-researcher in current MPC projects

Current associations

Australian Association Musculoskeletal Medicine (AAMM), 1980-present
International Association for the Study of Pain (IASP), 1990-present
Australian Faculty of Musculoskeletal Medicine (AFMM), 1995-present
International Spinal Injection Society (ISIS), 1996-present
Australian Pain Society, 1997-present

Practice Style

Dr David Vivian has been the director of multidisciplinary musculoskeletal clinics since 1984. These clinics historically and currently are most commonly secondary and tertiary referral clinics. Patients are referred specifically for the following treatments or programs:

Pain management assessment
Pain management programs
Functional assessment
Functional restoration
Post-operative rehabilitation

Over many years, Dr Vivian has attended and/or supervised numerous cadaver course in anatomy, needle intervention and neuromodulation. These have entailed the combined use of anatomical dissection with placement of needles, leads and batteries under fluoroscopic vision. Courses attended in 2010 included the Neuromodulation Cadaver course in Adelaide sponsered by St Jude (13th - 14th August, 2010). Dr Vivian's practise is a full referral practice. He has consulted on musculoskeletal pain medicine for over 30 years. MSC and MPCs receive over 4,000 patient referrals each year.

In Dr Vivian's practice he has performed in excess of:

10000 epidurals including transforaminal, caudal and interlaminar epidurals.
10000 radiofrequency neurotomies of the cervical, thoracic, lumbar and sacral dorsal rami or branches.
10000 joint injections as well as many other suitable musculoskeletal injections.
200 peripheral nerve or spinal cord stimulation trials or implants.

Dr David Vivian has appeared in court as an expert witness on about 200 occasions, but rarely since 2006. He has been an accredited workcare assessor on matters musculoskeletal.

Teaching and speaking experience

Casual lecturer in musculoskeletal medicine to the RACGPs, 1981-present
Plenary speaker at numerous Annual Scientific Meetings of the Australian Association Musculoskeletal Medicine, 1982-1997
Invited speaker at the College of Sports Medicine annual scientific Meetings, 1990 and 1999.
Speaker at the satellite meeting for the IASP meeting in Perth , 1990
Lecturer to Registrars in the orthopaedic training program of the Royal Australasian College of Surgeons, 1992-1993.

Dr Vivian has given numerous lectures to RACGP, Divisions of General Practice, Physiotherapy and other bodies over the years. As a guide, the lectures given in 1999 were:

RACGP trainees: “Management of Back Problems In General Practice – Latest Evidence”
Physiotherapy Masters programme: “Interventional Medical Management of Back Pain”
Physiotherapy Pain Group : “Medical Management of Back Pain”
Divisions of General Practice:
- “Acute Pain Management In General Practice”
- “Physical Medicine in the Management of Chronic Pain”
- “Physical Medicine in the Management of Acute Pain”
- Merck, Sharp, Dome series: “The Role of Musculoskeletal Medicine in Acute Pain Management

Dr Vivian has written teaching guidelines for the RACGP. Since 1981, he has regularly, at least on an annual basis, conducted lectures for the Family Medicine Training Programme, and the College of GP ’s. Topics include: The Management of Spinal Pain Problems (cervical, thoracic and lumbar), and Management of Shoulder Disorders.

Dr Vivian also regularly lectures to Post-Graduate Physiotherapy training courses, Nursing Groups, and have in the past lectured the undergraduate Health Sciences students. He has conducted many pre- and post-conference courses over the last 20 years.

Publications

Verrills P, Bogduk N, Vivian D. Lumbosacral internal disc disruption syndrome: Role of diagnostic imaging. In: DePalma M. eds. iSpine: Interventional Spine Care. 2011. Demos Medical
Vivian D. Discogenic pain, internal disc disruption and radicular pain. In: Lennard TA, Walkowski SA, Singla KA, Vivian D eds. Pain Procedures in Clinical Practice; 3rd Edition 2011. Elsevier
Vivian D. Intradiscal and peridiscal therapies for discogenic and radicular pain. In: Lennard TA, Walkowski SA, Singla AK, Vivian D eds. Pain Procedures in Clinical Practice; 3rd Edition 2011. Elsevier
Vivian D. Discogenic pain, internal disc disruption and radicular pain. In: Lennard TA, Walkowski SA, Singla AK, Vivian D eds. Pain Procedures in Clinical Practice; 3rd Edition 2011. Elsevier
Mitchell B, Vivian D. Sacroiliac joint pain: procedures for diagnosis and treatment. In: Lennard TA, Walkowski, SA, Singla AK, Vivian D eds. Pain Procedures in Clinical Practice; 3rd Edition 2011. Elsevier
Vivian D. Discography. In: Lennard TA, Walkowski SA, Singla AK, Vivian D eds. Pain Procedures in Clinical Practice; 3rd Edition 2011. Elsevier
Vivian D, Verrills P. Pathophysiology of painful cervical spine disorders. In: DePalma M. eds. iSpine: Interventional Spine Care. 2011. Demos Medical
Mitchell B, McPhail T, Vivian D, Verrills P, Barnard A. Diagnostic sacroiliac joint injections: Is a control block necessary?Journal of Science and Medicine in Sport 2010; 12 (Suppl) 2:e5-e6
Verrills P, Mitchell B, Vivian D, Sinclair C. Peripheral Nerve Field Stimulation: Is Age an Indicator of Outcome? Neuromodulation 2009 12: 60-67
Verrills P, Mitchell B, Vivian D, Sinclair C.Peripheral Nerve Stimulation: A Treatment for Chronic Low Back Pain and Failed Back Surgery Syndrome? Neuromodulation 2009 12:68-75
Verrills P, Mitchell B, Vivian D, Nowesenitz G, Lovell B, Sinclair C. The incidence of intravascular penetration in medial branch blocks: cervical, thoracic, and lumbar spines. Spine 2008 15;33:E174-7
Vivian D: Fibromyalgia. In Springer eds: Encyclopedia of Pain. Berlin Heidelberg. 2007 and 2010
Vivian D: Validity. In Springer eds: Encyclopedia of Pain. Berlin Heidelberg. 2007
Vivian D: Reliability In Springer eds: Encyclopedia of Pain. Berlin Heidelberg. 2007
Verrills P, Vivian D. Interventions in chronic low back pain; a review. Aust Fam Physician. 2004 33(6):421-6.
Verrills P, Mitchell B, Vivian D, Sinclair C, Barnard A. Peripheral Nerve Field Stimulation for Chronic Pain: 100 cases and review of the literature. Pain Med. 2011 Sep;12(9):1395-405
Vivian D, Jensen S, Wilk V. Unit 464 November 2011: www.racgp.org.au/check
Vivian D. Management of Zygapophyseal Joint Pain By Radiofrequency Denervation, Bulletin AAMM, July 1985
Vivian D.·The Cervical Spine: Function and Dysfunction. Bulletin AAMM, June 1986
Vivian D. The Cervical Spine: Traction.·Bulletin AAMM, September 1985
Vivian D. Shoulder Pain. Bulletin AAMM, September 1985
Vivian D.·The Slump Test. Bulletin AAMM, January 1988
Vivian D.·Epidural Injections. Bulletin AAMM, March 1990
Vivian D.·Osteoporosis. Bulletin AAMM, March 1993
Vivian D.·The Use of MRI. Bulletin AAMM, April 1994
Clinical Practice guidelines for Chronic Knee Pain, 1999-2002
Co-author – NHMRC guidelines for the management of acute anterior knee pain, 2003.·http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp95.pdf
Co-author of the LowBackPain™ - CD-Rom: A Clinical Guide to Low Back Pain - educational textbook·lowbackpain.tv video series
White papers for AFMM on fibromyalgia, neurogenic pain, validity, reliability and cervical epidural injection.
Book review:·"Whiplash: evidence base for clinical practice" (2012)·http://www.mja.com.au/public/bookroom/bookroom.html·