Musculo Skeletal Physician
Dr. Tim Barling Dip MS Med
Associate Specialist in Musculoskeletal Medicine 2000
Diploma in Musculoskeletal Medicine 1998
Member British Institute of Musculoskeletal Medicine 1998
Dr. Barling is a General Practitioner who worked in Spinal and
General Orthopaedics with Mr. Vic Seal in Hereford for 15 years
before specialising in Musculoskeletal Medicine. He helped to
set up the Herefordshire Musculoskeletal Clinic with Robert
Blackburn and Tim Holt in 2000. This is an NHS
'multi-disciplinary' clinic which treats much the same type of
problems as we do at Kyrle House.
What is a Musculo-Skeletal Physician?
A Musculoskeletal Physician is a doctor who is qualified to treat disorders of the spine and limbs that do not require surgical intervention.
Such problems include osteoarthritis or "wear and tear", malfunction due to occupational or sport-related injury, mechanical instability and various types of soft tissue inflammation.
Working as he does at Kyrle House, Dr. Barling will sometimes be called upon to treat back problems which have failed to respond to Osteopathy or Physiotherapy. However, he also accepts direct referrals from the patient's General Practitioner.
Dr. Barling specialises in diagnosing and treating spinal and limb problems with a number of different non-surgical methods. He has close links with Orthopaedic and Spinal Surgeons, both in Hereford and beyond, should referral for surgery be needed.
These are examples of conditions that Dr. Barling treats and some of the modalities he uses to treat them.
Mechanical Back Pain- manipulation, acupuncture, facet joint injection, prolotherapy.
Dr. Barling carries out facet joint injection under x-ray control at the County Hospital.
Prolotherapy is a type of non-steroid injection, given as a course of three, used to strengthen weakened ligaments in the back.
(lumbar nerve root pain) - epidural, nerve root
Dr. Barling carries out epidural here in the practice and nerve root block under x-ray control at the County Hospital.
Images of Lumbar Spinal MRI scan and X-ray guided root block injection
Osteoarthritis of the knee - cortisone injection, acupuncture, dextrose prolotherapy.
Dextrose Prolotherapy is a type of non-steroid injection, given as a course of three, which has been shown to improve healing in the arthritic knee; it is particularly useful when the condition does not warrant surgery or when the patient prefers a non-surgical approach.
Shoulder pain (rotator cuff pain, impingement syndrome, arthritis, frozen shoulder) - cortisone injection, hyaluronic acid injection, exercise therapy.
He uses hyaluronic acid injections for recurrent impingement pain of the shoulder - these are a type of non-steroid injection, given as a course of three, that improve healing in joints (some doctors use them for knee arthritis) - evidence has shown marked benefit for this type of shoulder pain.
He uses cortisone injection together with a specific exercise programme for Frozen Shoulder. Sometimes repeat injection or physiotherapy are needed (or referral for Manipulation under anaesthetic if the problem persists).
Dr. Barling is happy to see patients with any type of spinal or limb problem if only to help make a firm diagnosis.
Often conservative management with advice on lifestyle changes, exercises, improvement in workplace ergonomics and reassurance are all that is needed.
Sometimes he will give an opinion on a patient's condition and refer them for Osteopathic treatment, Physiotherapy or Soft-tissue Massage if he feels that is the best way forward.
The advantage of the set-up at Kyrle House is the multi-disciplinary nature of the service - practitioners can inter-refer quickly and efficiently.
Where interventional treatment is needed Dr. Barling will provide explanation and information leaflets which address each aspect of the procedure.
Dr Barling has close links with local X-ray amd MRI services.
Musculo-Skeletal Medicine links:
Society of Orthopaedic Medicine: www.somed.org
British Institute of Musculo-Skeletal Medicine: www.bimm.org.uk