Carl Nottoli, DC
Voice those concerns directly. You have treated all relevant MSK problems that are fixable and if there’s not any other MSK structural pathology present it’s not MSK.
This highly suggests psychosocial overlay or other non-MSK pathology. Make sure you lay out the facts simply and with the concerns you have mentioned. This patient doesn’t need further conservative care. Ask them to contact you when they’ve made the appointment with another provider so you can stay up to date with their progress.