Dr Vivian has managed medical problems that cross many traditional specialist boundaries, such as cervical and lumbar disc prolapse and radiculopathy, shoulder joint disorders, arm pain, pelvic pain, hip, knee and ankle disorders including meniscal and ligament injuries, and chronic widespread pain disorders such as fibromyalgia and osteoarthritis. He has run and worked in multidisciplinary pain clinics. Thus, he has an extensive and eclectic capability of commenting on the role of conservative versus non-conservative management including the relevance of pain interventions, surgery and pain management programs.