Ian Wallbridge
Ian was a General Practitioner from 1995 to 2005 in Rotorua after postgraduate diplomas in paediatrics and obstetrics, with a practice skewed toward children and obstetrics. He then developed an interest in nutritional and environmental medicine and musculoskeletal medicine, and with a post graduate diploma in both of these he proceeded tospecialise in musculoskeletal medicine, and worked full time in this area from 2006. He consults by referral from Lakes MRI at 1203 HaupapaStreetRotorua, and has recently started a needling service at Southern Cross hospital on Fridays performing medial branch blocks to try and localise the source of nocioception in the cervical (and sometimes thoracic and lumbar) region for chronic somatic cervical pain, lumbar transforaminal epidurals for lumbar radicular pain, and sacroiliac joint blocks for chronic sacroiliac somatic pain. All this is a ‘ free for the patient’ service with an accepted ACC claim, which is particularly useful for patients who have often been financially stressed by the results of an accident with pain and work absence, and makes GP’s lives easier knowing there is an easy referral path for such patients to obtain help. Musculoskeletal medicine is an eclectic approach, attempting, if possible, to localise the source of nocioception, and then treat with either “pills and skills” rather than surgery. Pills can be the use of standard medication, but also guiding patients in complementary medicine – as many use this area, after being tried by chronic musculoskeletal pain. Skills may involve patient centred postural advice, exercises, trigger point release, stretching, breathing, cognitive processes and understanding of the pain process, or physician based laser, neuromuscular therapy mobilization, or the above mentioned needling. Dr Ian Wallbridge Musculoskeletal Physician Australasian Faculty of Musculoskeletal Medicine Email: iwallbridge@xtra.co.nz Phone: 07 348 7312
Musculoskeletal Medicine (Part 1) Pre-conference Workshop   Thursday, 12 June 2014 Start 8:30am Duration: 120mins Room 2 Introduction to Neuromuscular medicine. Key history points. The Role of Diet. Neutraceuticals. Myofascial Pain.  Hands on demonstrations   Musculoskeletal Medicine (Part 2) Pre-conference Workshop  Thursday, 12 June 2014 Start 11:00am Duration: 120mins Room 2 Continuation on Basic Hands On Techniques   Musculoskeletal Masterclass 1 Pre-conference Workshop  Thursday, 12 June 2014 Start 2:00pm Duration: 120mins Room 2 Cervical and Thoracic Spine Advanced techniques Experienced practitioners only This session is a hands on practical session for more advanced practitioners concentrating on key assessment and treatment techniques that can be used in your office on Monday. They will help you and the MSK patients that WILL be presenting with these problems. Thoracic spines are easy. Torn discs are rarely a factor, so the presenting problems are generally to do with joint (including costovertebral joint) movement and muscle support. They happen logically and respond in the same way. NSAIDs are fine for the acute inflammatory component; the underlying mechanical drivers need addressing also. There are a variety of simple, practical mobilising techniques that can be used to free up the joints. An excessively kyphotic thoracic spine underlies and drives most neck problems. This thoracic hunching is becoming hugely common, as people bend even more over the small IT devices like laptops, iPads, tablets and smartphones. The iHunch requires the patient to overuse the posterior neck muscles just to look ahead. This in turn compresses the facet joints, setting up acute joint locking, cervicogenic headache, closing down of the IV foramina, etc. There are various simple, effective techniques to free up the thoracic joints which can be performed by the GP, and others which the patient can follow on with at home. The second common presentation is unilateral chest pain with pain on full inspiration - generally left-sided as patients present thinking they might be having a heart attack. Once serious pathologies have been checked out and excluded, what remains is acute locking of one or more CV joints, with referral around the costal nerve(s) to the front. These respond to straightforward unlocking techniques, and patient gratitude on discovering it’s only a simple mechanical problem is large.   Musculoskeletal Masterclass 2 Pre-conference Workshop  Thursday, 12 June 2014 Start 4:30pm Duration: 120mins Room 2 Lumbar and Sacroiliac Spine Advanced techniques Experienced practitioners only This session is a hands on practical session for more advanced practitioners concentrating on key assessment and treatment techniques that can be used in your office on Monday. They will help you and the MSK patients that WILL be presenting with these problems.