Content and purpose

The course is starting in a different format at Macquarie University. Details are listed above.

The course is designed to give general practitioners skills in accurate diagnosis and initiation of appropriate management in musculoskeletal problems.  There is strong grounding in musculoskeletal medicine including peripheral joints and soft tissue pain with emphasis on spinal pain.  Our course equips the doctor to arrange a management program and supervise therapy.  These skills are especially relevant in back pain and recognition of pathology with musculoskeletal manifestations is emphasized as are the risk factors associated with development of chronic pain syndrome.

Physical Medicine

Physical medicine is defined as the management by medical practitioners of acute or chronic musculoskeletal injury, disease and dysfunction – impaired or altered function of related components of the somatic (body frameworks) system.  This involves skeletal, arthrodial and myofascial structures with subsequent related vascular, lymphatic and neural elements (Hospital Adaptation of International Classification of Diseases, 2^nd Edition, 1973).  Treatment includes the application of physical modalities such as heat, cold and manual therapy.  Other therapies such as pharmaceuticals or injection technique and exercise are also used to restore normal function.

The course is designed for general practitioners.  Candidates are required to hold the degrees MBBS and to be registered medical practitioners in Australia.  Overseas participants will be considered.  The diploma course is offered by the Australian College of Physical Medicine.  A committee with representation from the main subject areas within the course oversees the curriculum and the implementation of the diploma course.

The Diploma in Physical Medicine course is conducted by coursework part-time over two years.  It will require six weeks of full-time attendance at practical courses held in Sydney.  These practical courses are each of one week’s duration, held on three occasions in each of the two years of the course.  Coursework includes:

Lectures

Tutorials (including case study/problem-based learning)

Practical classes including anatomy laboratory

Continuing Medical Education (CME) points are available subject to the Royal Australian college of GP’s (RACGP) review.  

Fees

The fee per annum is $8,250.  To facilitate payment course fees can be paid on a per semester basis at $2,750.  There will be an additional cost for GST.

Syllabus

Semester 1

ANATOMY OF AXIAL SKELETON

Cervical

Thoracic

Lumbar

SPINAL DIAGNOSIS I

Patterns of Spinal Pain

A Diagnostic Approach to Spinal Pain

The Concept of Irritability

Low Back Pain: Clinical Features

Examination of Lumbar Spine

Lumbar Disc Herniation Assessment and Treatment

The Thoracic Spine: Clinical Features

Examination of the Thoracic Spine

The Cervical Spine: Clinical Aspects

Examination of the Cervical Spine

Manual Therapy: Mobilisation/Manipulation of Lumbar and Thoracic

Validation of Mobilisation and Manipulation

Reading List:

Kenna Clive, Murtagh John "Back Pain & Spinal Manipulation" (Butterworths)

Bogduk N, Twomey L “Clinical Anatomy of Lumbar Spine”

Gross J, Fetto J, Rosen E “Musculoskeletal Examination” (Blackwell Science)

Kahle W, Leonhardt H, Platzer W “Colour Atlas/Text of Human Anatomy Volume 1 LOCOMOTOR SYSTEM” (Thieme)

Semester 2

ANATOMY LAB

Anatomy Tutorials with prosected specimens; intensive hands on sessions covering all sections of the locomotor systems:

-         Axial

-         Peripheral

Danger zones to avoid in injection therapy

SPINAL DIAGNOSIS II

Intervertebral Dysfunction

The Cellulo-Periostial-Myalgic Syndrome of Maigne

Soft Tissue Changes of Spinal Origin

Upper Cervical/ Headache and Facial pain

Lower Cervical

Upper Thoracic

Costo-vertebral

Lower Thoracic

Lumbar

Transitional Zone Syndromes:

-         Cervico-thoracic, neck, shoulder, interscapular pain

-         Thoraco-lumbar, low back, psuedo hip/ psuedovisceral pain

-         Lumbo-sacral, leg pain and psuedo sciatica

Manual Therapy- Manipulation

IMAGING OF AXIAL MUSCULOSKELETAL SYSTEM

BIOMECHANICS OF AXIAL SKELETON

-         Cervical

-         Thoracic

-         Lumbar

RHEUMATOLOGY, SYSTEMIC DISEASES AND MALIGNANCIES IN MUSCULOSKELETAL MEDICINE

Classifications

When to refer

Reading List

Maigne  R “Diagnosis and Treatment of Pain of Vertebral Origin” (Williams & Wilkins 1996)

Kapandji I “The Physiology of the Joints” Vol 3 The Trunk and the Vertebral Column (Churchill Livingstone)

Anderson J, Read J, Steinweg J “Atlas of Imaging in Sports Medicine” (McGraw Hill)

Semester 3

APPLIED SPINAL BIOMECHANICS

Somatic dysfunction: the approach of North American manual medicine therapists:

-         Diagnostic triad

-         Vertebral motion analysis

-         Osteopathic manipulation

-         Muscle energy techniques

-         Myofascial release

-         Positional release

-         Ligamentous articular release

-         Torque unwinding techniques

Reading List:

Greenman P “Principles of Manual Medicine” (Williams & Wilkins)

Bourdillon J, Day E, Bookhout M “Spinal Manipulation (Butterworth Heinmann)

Chaitow L “Positional Release Techniques” (Churchill Livingstone)

Semester 4

MYOFASCIAL PAIN SYNDROME PRINCIPLES DEVELOPED BY TRAVELL AND SIMONS

Pain referral patterns

Injection techniques

Muscle release techniques

Exercise prescription

BIOMECHANICS OF PERIPHERAL JOINTS

APPLIED BIOMECHANICS OF PERIPHERAL JOINTS – Nordic approach of Kaltenborn and Evjenth

Principles of translatoric joint movements

Kaltenborn convex and concave rule

RADIOLOGY OF PERIPHERAL JOINTS

PERIPHERAL JOINT INJECTIONS – Use of models

PRINCIPLES OF CORTICOSTEROID INJECTIONS

Reading List:

Travell J, Simons D “Myofascial Pain and Dysfunction – the trigger point manual Vol 1 and 2” (Williams & Wilkins)

Kaltenborn F “Manual Mobilisation of the Joints – the extremities”

Kapandji I “The Physiology of the Joints Vol 1 and 2 – upper and lower limb” (Churchill Livingstone)

Anderson J, Read J, Steinweg J “Atlas of Imaging in Sports Medicine” (McGraw Hill)

Semester 5

PELVIC DYSFUNCTION

Biomechanics

Anatomy

Diagnosis

Treatment

RIB DYSFUNCTION

Biomechanics

Anatomy

Treatment

REGIONAL PAIN SYNDROMES

Integration of paradigms

POSTURAL DYSFUNCTION – approach of Lewit and Yanda

Analysis

Treatment algorithm

Therapeutic exercise prescription

NEUROBIOLOGY OF PAIN

Neuroscience of pain:

-         Neuroanatomy

-         Physiology

-         Pharmacology

-         Biochemical

-         Psychosocial

Pain presentations:

-         Aetiology

-         Pathways

-         Clinical manifestations

PHARMACOLOGY OF PAIN

Pharmacokinetics

Pharmacodynamics

DIAGNOSTIC STRATEGIES IN PAIN MANAGEMENT

Evidence for diagnostic and treatment procedures

Reliability and validity of assessment instruments and strategies

UNDERSTANDING EVIDENCE BASED RESEARCH IN MUSCULOSKELETAL MEDICINE

How to read a scientific paper – the basics of evidence based medicine

Reading List:

Liebenson C “Rehabiliation of the Spine” (Williams & Wilkins)

National Health and Research Council “Evidence-based Management of Acute Musculoskeletal Pain” (Australian Academic Press)

Bland M “An Introduction to Medical Statistics” (Oxford)

Lewit K “Manipulative Therapy in Rehabilitation of the Locomotor System” (Butterworth Heinemann)

Semester 6

MANAGEMENT OF CHRONIC PAIN

INTEGRATION OF TREATMENT PARADIGMS

Diagnosis and treatment of multi-regional dysfunctions

OVERVIEW OF COURSEWORK

FINE TUNING OF DIAGNOSTIC AND HAND SKILLS

EXAM PREPARATION

Reading List:

Handouts