Road to recovery: Are non-surgical remedies the solution to MSK?

Part 2 in an ongoing series about MSK conditions and how advisers are changing their approach to treatment with new benefit solutions. Read part 1 here.

Imagine being not only a benefits adviser, but also a chiropractor and licensed acupuncturist navigating your way through crippling MSK. Meet Mark Testa, executive vice president of Regenex, who checks all three boxes. His company offers platelet-rich plasma (PRP) and bone marrow concentrate injections to help people avoid surgery, which turned out to be both highly convenient and efficacious. 

He traces severe neck, arm and shoulder blade pain back to head or neck trauma and whiplash-related injuries associated with playing football in his youth, as well as a few car and bicycle crashes. The final straw was an incident involving jumping off his basement floor during plyometrics, which seriously compressed his neck and triggered a spiral of constant and unrelenting pain. 

His self-prescribed treatment involved chiropractic adjustments and some dry needling, which worsened his condition to a point where it would flare up just from stretching. An MRI revealed enough nerve compression, flattening of the spinal cord and degenerative changes that would send most patients to an orthopedic or spine surgeon's office. 

Read more: To reduce healthcare costs, address chronic conditions

Having practiced as a clinician for more than 30 years, he saw the downside of spinal fusions and did not want any part of it. So, about five years ago he had platelet injections in his neck and an epidural instead of steroids, then had his joints treated and ligaments tightened up, which was a game changer as far as pain for about three and a half years. He also weaned himself off pain meds. "I saw four opioid deaths in one quarter and was like, 'Well, I don't want to go down that road for too long,'" he says. 

Then his young daughter jumped on him and wrapped her arms around his neck at the same time. Testa felt a crack and had immediate pain. It has been two years since he had a second round of platelets injected in the epidural space into joints and ligaments. 

There was no specific injury to David Contorno, founder and president of E Powered Benefits whose right outer thigh was inflamed in January 2024 and drove sciatic leg pain that worsened and traveled down to his ankle. 

Like Testa, he pursued non-surgical options that included physical therapy, stretching, chiropractic care and cupping, which is an alternative medicine technique that involves placing glass, bamboo or plastic cups on the skin to create suction. Like Silverman, though, he ended up receiving the same surgical treatment. 

Read more: How employers can save $3,000 per employee on MSK care 

Eventually an MRI showed a bulging disc whose pain he sought to mask with handfuls of Advil, but the worst was yet to come. Little did he realize ibuprofen and non-steroidal anti-inflammatory drugs that reduce pain, inflammation and fever can also contribute to fluid retention and potentially exacerbate dehydration. 

"I started feeling really unwell, and then I got a gastrointestinal bug," he remembers, which led to vomiting and diarrhea, which caused further dehydration. "I couldn't walk. I would get out of breath within seconds of just getting out of bed, and because I couldn't get out of bed, I was taking really bad care of myself, and everything was just spiraling worse and worse by the day." 

Read more: Beyond opioids: Ending chronic pain through workplace intervention

His wife Emma Fox, who's CEO and co-owner of his company, convinced him to get an epidural to manage the pain. Upon discovering dangerously low blood pressure, he was rushed to the emergency room and diagnosed with acute kidney failure. At a subsequent inpatient hospital stay for five days, he was given oxycodone several times a day and sent home with a prescription, which was taken less than prescribed and then discarded after about three or four weeks. Just days later, he was in withdrawal — vomiting and experiencing night sweats, giving Contorno a front-row seat to the nation's opioid epidemic. 

Several doctors, including his good friend Alex Lickerman, M.D., founder and chief medical officer of ImagineMD, noted that while many surgeries that address MSK issues are done unnecessarily, he was in fact a good candidate for surgery. One of the nation's top orthopedic surgeons recommended someone in his city, whose office told him they were booking four to six weeks out. But upon learning he'd be a cash-pay customer, Contorno was able to make an appointment for the very next day. A tiny incision to lob off the bulging part of the disc was made as part of a microdiscectomy, thus ending a frightening medical drama. 

Stay tuned for the next part of the series, live on Monday, to find out how these advisers recovered — and what it meant for their approach to benefits moving forward.