What is the Cost of Treating Frozen Shoulder (Adhesive Capsulitis of the Shoulder)?

Severity Levels of Frozen Shoulder (Adhesive Capsulitis of the Shoulder)

Frozen shoulder, also known as adhesive capsulitis, can vary in severity. Understanding the different levels can help patients and healthcare providers determine the most appropriate course of treatment. Let's explore the three main severity levels: mild, moderate, and severe.

Mild

Mild cases of frozen shoulder are often the earliest stage of the condition.

• Symptoms: Patients experience slight pain and stiffness, with minimal limitation in range of motion. The discomfort is usually manageable and may not significantly interfere with daily activities.
• Risk factors: Recent shoulder injury, diabetes, or thyroid disorders can contribute to the development of mild frozen shoulder.
• Diagnosis: Often, patients can self-assess their condition or consult with a doctor virtually for an initial evaluation.
• Imaging/Labs: At this stage, imaging or laboratory tests are usually not necessary for diagnosis.
• Treatments: Management typically involves over-the-counter pain relievers and gentle stretching exercises to maintain mobility.

Moderate

As the condition progresses, patients may experience moderate symptoms that are more noticeable and impactful.

• Symptoms: Increased pain and stiffness are common, with a noticeable limitation in range of motion. Daily activities may become more challenging.
• Risk factors: Prolonged immobilization of the shoulder (e.g., after surgery or injury) and age (typically 40-60 years) are associated with moderate cases.
• Diagnosis: An in-person doctor consultation is usually necessary for a proper evaluation.
• Imaging/Labs: X-rays may be ordered to rule out other conditions that could be causing the symptoms.
• Treatments: Management often includes prescription pain medications, structured physical therapy programs, and possibly corticosteroid injections for pain relief.

Severe

In severe cases, frozen shoulder can significantly impact a patient's quality of life.

• Symptoms: Intense pain and significant loss of mobility are hallmarks of severe frozen shoulder. Daily activities and sleep can be severely affected.
• Risk factors: Previous episodes of frozen shoulder, cardiovascular disease, and long-term diabetes can increase the risk of developing severe symptoms.
• Diagnosis: In-person doctor consultation is crucial, often with a referral to an orthopedic specialist for comprehensive evaluation.
• Imaging/Labs: MRI or ultrasound may be recommended to assess the extent of the condition and rule out other shoulder pathologies.
• Treatments: Management typically involves intensive physical therapy, and may include more invasive procedures such as hydrodilatation, manipulation under anesthesia, or in rare cases, surgery.

Summary Table: Severity Levels

Understanding these severity levels can help patients and healthcare providers make informed decisions about the most appropriate and cost-effective treatment strategies for frozen shoulder.

Getting a Diagnosis

Getting an accurate diagnosis is the crucial first step in treating frozen shoulder (adhesive capsulitis of the shoulder). The method you choose can significantly impact both the cost and the time it takes to begin treatment. Let's explore the various options available:

Self-assessment

• Cost: $0
• Time: Immediate
• Appropriate for: Mild cases or initial evaluation

Self-assessment is the most cost-effective option but should only be used for mild cases or as an initial evaluation. While it doesn't incur any direct costs, it's important to note that misdiagnosis could lead to delayed treatment and potentially higher costs in the long run.

Virtual doctor consultation

Virtual consultations have become increasingly popular, offering a balance between cost-effectiveness and professional medical advice. Here are some options:

1. Teladoc
   • General Medical Visits:
     • Without insurance: $89 per visit
     • With insurance: As low as $0 per visit, depending on benefits
   • Therapy:
     • Without insurance: $99 per session
     • With insurance: $0-$99 per session, depending on coverage
   • Psychiatry:
     • Without insurance:
     • First-time visit: $299
     • Follow-up visits: $119
     • With insurance:
     • First-time visit: $0-$299
     • Follow-up visits: $0-$129
   • Dermatology, Nutrition, and Back and Joint Care: Prices vary
2. MDLive Without insurance:
   • Urgent Care: $0 to $82
   • Primary Care: As low as $0 (only offered through selected health care insurance plans)
   • Dermatology: $0 to $95
   • Mental Health Therapy: $0 to $108
   • Mental Health Psychiatry: $0 to $284 (initial session $284, follow-up sessions $108)
   • Urgent Care: $82
   • Therapy Session: $108
   • Psychiatry Session: $284
   • Dermatology: $95
3. OptimalMD
   • Cost: Free with OptimalMD membership ($47 per month for the entire family)
   • Time: Same-day or next-day appointment, 15-30 minutes

OptimalMD offers a compelling option for those seeking regular medical care, including virtual consultations for conditions like frozen shoulder. The $47 monthly family membership includes unlimited virtual urgent care consultations, making it a cost-effective choice for families or individuals who anticipate needing multiple consultations throughout the year.

In-person doctor consultation

For moderate to severe cases, an in-person consultation might be necessary. Here are some options:

1. Primary Care Physician (PCP) Visit
   • With insurance: Copay typically ranges from $15 to $25, but can vary based on your specific plan
   • Without insurance: Average cost is $171, but can range from $100 to $200+
   • Time: 1-3 days for appointment, 30-45 minutes for the visit
2. Urgent Care Center Visit
   • Without Insurance: The average cost is around $258
   • With Insurance: $150 to $300 before meeting the deductible, and $60 to $170 copay after meeting the deductible
   • Time: Same-day service, typically 1-2 hours wait time, 15-30 minutes for the visit
3. OptimalMD In-Person Visit
   • Cost: Heavily discounted with OptimalMD membership
   • Time: Varies based on local availability

Orthopedic specialist consultation

For severe cases or when recommended by a primary care physician:

• With insurance: Copay typically ranges from $30 to $50, but can vary based on your specific plan
• Without insurance: Average cost ranges from $84 to $167, depending on the state and location
• OptimalMD: Heavily discounted with OptimalMD membership
• Time: 1-2 weeks for appointment, 45-60 minutes for the visit

When choosing a diagnostic option, consider both the severity of your symptoms and your financial situation. While self-assessment and virtual consultations are more cost-effective for mild cases, moderate to severe cases may require in-person or specialist consultations for accurate diagnosis and treatment planning.

Here's a summary table of the diagnostic options:

Summary Table: Assessment Options

Remember, early and accurate diagnosis is key to effective treatment of frozen shoulder. While cost is an important factor, ensuring you receive appropriate care should be the primary consideration in your decision-making process.

Imaging and Laboratory Tests

When diagnosing and monitoring frozen shoulder (adhesive capsulitis of the shoulder), various imaging and laboratory tests may be necessary. The choice of test depends on the severity of the condition and the healthcare provider's assessment. Here's a breakdown of common tests, their costs, and time estimates:

X-rays

X-rays are often the first imaging test ordered for frozen shoulder to rule out other conditions or assess bone structure.

• RadiologyCenter:
  • Cash price: $109
  • With insurance: Varies, typically $30-$50 copay
  • Discount card: $130
• HospitalImaging:
  • Cash price: $150
  • With insurance: Varies, typically $40-$60 copay
• Free with OptimalMD membership

Time: Same-day results, 15-30 minutes for the procedure

MRI

An MRI may be ordered for severe cases or when the diagnosis is unclear. It provides detailed images of soft tissues.

• AdvancedImaging:
  • Cash price: $1,874
  • With insurance: Varies, typically $100-$300 copay
  • Discount card: $1,500
• HospitalImaging:
  • Cash price: $2,500
  • With insurance: Varies, typically $150-$400 copay
• Heavily discounted with OptimalMD membership

Time: 1-3 days for results, 30-60 minutes for the procedure

Ultrasound

Ultrasound can be useful for visualizing soft tissue and guiding injections in frozen shoulder cases.

• SonoClinic:
  • Cash price: $250
  • With insurance: Varies, typically $50-$100 copay
  • Discount card: $200
• HospitalImaging:
  • Cash price: $350
  • With insurance: Varies, typically $75-$150 copay
• Heavily discounted with OptimalMD membership

Time: Same-day results, 30-45 minutes for the procedure

Blood Tests

While not always necessary, blood tests may be ordered to rule out underlying conditions that can contribute to frozen shoulder, such as diabetes or thyroid disorders.

• LabCorp:
  • Cash price: $49.00
  • With insurance: Varies, typically covered with a small copay
  • Discount card: $39
• Quest Diagnostics:
  • Cash price: $55
  • With insurance: Varies, typically covered with a small copay
• Free with OptimalMD membership

Time: 1-3 days for results, 15 minutes for blood draw

It's important to note that while these tests can be crucial for accurate diagnosis and treatment planning, they also contribute significantly to the overall cost of managing frozen shoulder. Patients should discuss the necessity and potential alternatives with their healthcare provider. For those with OptimalMD membership, many of these tests are either free or heavily discounted, which can substantially reduce out-of-pocket expenses.

Summary Table: Diagnostics

Note: All tests are either free or heavily discounted with OptimalMD membership ($47/month for the entire family).

Prescription Medications

Prescription medications play a crucial role in managing frozen shoulder (adhesive capsulitis of the shoulder), particularly for pain management and reducing inflammation. The choice of medication often depends on the severity of the condition and the patient's individual needs. Here are some common prescription medications used in treating frozen shoulder, along with their costs and suppliers:

NSAIDs (e.g., Naproxen, Ibuprofen)

NSAIDs are often the first line of prescription treatment for frozen shoulder due to their anti-inflammatory and pain-relieving properties.

1. Naproxen (generic)
   • Dosage: 500mg tablets, 60 count
   • Suppliers and prices:
     • CVS Pharmacy: $69.59 (cash price), $4.52 (with SingleCare discount card)
     • Walgreens: $72.99 (cash price), $9.99 (with Walgreens Prescription Savings Club)
     • Free with OptimalMD membership
2. Ibuprofen (brand name: Motrin)
   • Dosage: 800mg tablets, 30 count
   • Suppliers and prices:
     • Rite Aid: $33.32 (cash price), $2.37 (with SingleCare discount card)
     • Walmart: $30.00 (cash price), $4.00 (with Walmart Rx Program)
     • Free with OptimalMD membership

Most insurance plans cover these medications, often with a copay of $5-$20 depending on the plan.

Oral corticosteroids (e.g., Prednisone)

Oral corticosteroids may be prescribed for short-term use to reduce inflammation in more severe cases of frozen shoulder.

1. Prednisone (generic)
   • Dosage: 20mg tablets, 21 count (typical for a tapered dose)
   • Suppliers and prices:
     • CVS Pharmacy: $235.00 (cash price), $12.11 (with GoodRx coupon)
     • Walgreens: $238.99 (cash price), $14.54 (with WellRx coupon)
     • Free with OptimalMD membership

Insurance coverage for prednisone varies, but most plans cover it with a generic drug copay, typically ranging from $5-$20.

Muscle relaxants (e.g., Cyclobenzaprine)

Muscle relaxants may be prescribed to help reduce muscle tension associated with frozen shoulder.

1. Cyclobenzaprine (generic)
   • Dosage: 10mg tablets, 30 count
   • Suppliers and prices:
     • CVS Pharmacy: $54.02 (cash price), $4.48 (with SingleCare discount card)
     • Walgreens: $55.99 (cash price), $7.20 (with GoodRx coupon)
     • Free with OptimalMD membership

Most insurance plans cover cyclobenzaprine with a generic drug copay, typically ranging from $5-$20.

It's important to note that the effectiveness and appropriateness of these medications can vary depending on the individual case and severity of frozen shoulder. Always consult with a healthcare provider to determine the best treatment plan for your specific situation.

Summary Table: Prescription Medications

Note: All medications listed are free with OptimalMD membership ($47/month for the entire family).

Over-the-Counter Treatments

Over-the-counter (OTC) treatments can be an effective first line of defense for managing the pain and discomfort associated with frozen shoulder, especially for mild to moderate cases. These treatments are generally more affordable and accessible than prescription medications. Let's explore the various OTC options available, their costs, and where to find them.

Pain relievers (e.g., Acetaminophen, Ibuprofen)

Oral pain relievers are often the first choice for managing frozen shoulder pain. The two most common types are acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

1. Acetaminophen (Tylenol):

The average retail price for Tylenol Extra Strength is around $8.86 for a standard package. However, prices can vary significantly:

• With a GoodRx coupon, you can get the generic version for as low as $3.15.
• On Amazon, a 100-count pack costs $10.97.
• Prices at local pharmacies like CVS and Walmart may vary, but are generally competitive with these prices.

1. Ibuprofen (Advil, Motrin):

The cost of Advil products ranges from about $0.12 to $0.83 per tablet or capsule, depending on the specific formulation and package size. For a standard 100-count bottle of Advil Ibuprofen tablets, the price is around $12.49 at Walgreens.

It's worth noting that generic ibuprofen is often significantly cheaper than brand-name Advil. Many pharmacies offer their own generic versions at lower prices.

Topical pain relievers (e.g., Diclofenac gel)

Topical pain relievers can be applied directly to the affected area for localized pain relief. One popular option is diclofenac gel, available over-the-counter as Voltaren.

The cost of Voltaren Arthritis Pain Gel ranges from about $13.45 for a small 1.76 oz tube to $55.99 for a larger quantity pack. The standard 3.5 oz tube costs around $24-$26, depending on the retailer.

Generic versions of diclofenac gel may be available at lower prices. Additionally, some insurance plans may cover OTC topical pain relievers with a prescription from your doctor.

Hot/cold therapy products

Hot and cold therapy can help manage pain and improve flexibility in frozen shoulder. There are various products available for this purpose:

1. Reusable ice packs:
   • Amazon offers a reusable ice pack specifically designed for shoulder use at $19.99. However, prices can vary depending on the brand and features.
2. Heating pads:
   • Walgreens offers a range of electric heating pads, with prices ranging from $19.99 for a basic model to $54.99 for more advanced options.
   • The Walgreens brand heating pads tend to be more affordable, with prices between $19.99 and $36.99.
3. Hot/cold wraps:
   • While the specific price for a hot/cold therapy wrap at CVS is not available, these products typically range from $15 to $30, depending on the brand and features.

Summary Table: OTCs

Note: Prices may vary depending on location, retailer, and specific product. Insurance coverage for OTC treatments is typically limited but may be available in some cases with a prescription.

Procedures

Procedures for treating frozen shoulder (adhesive capsulitis of the shoulder) can vary in complexity and cost. Here's a detailed breakdown of the most common procedures, their costs, and efficiency:

Physical Therapy

Physical therapy is often the first-line treatment for frozen shoulder, especially for mild to moderate cases.

The national average cost for a physical therapy session ranges from $30 to $400. With insurance, patients typically pay $20 to $60 per session after meeting their deductible. Without insurance, out-of-pocket costs range from $50 to $155 per session.

Examples of providers and their costs:

• FYZICAL Therapy & Balance Centers: Costs vary by location and insurance coverage. They accept most major insurance plans and offer discounted rates for cash payments. For high-deductible plans, their office-based settings result in lower charges compared to hospital-based therapy.
• ATI Physical Therapy: $120 per hour for out-of-pocket payments. Costs with insurance vary based on individual plans and coverage.

Efficiency: Physical therapy typically requires 6-12 weeks of treatment, with 2-3 sessions per week. Improvement is gradual but consistent with proper adherence to the program.

Corticosteroid Injections

Corticosteroid injections can provide significant relief for moderate to severe cases of frozen shoulder.

The national average cost for a corticosteroid injection ranges from $108 to $1,054, depending on the specific type of injection and whether imaging guidance is used. With insurance, patients typically pay a copay or coinsurance after meeting their deductible.

Examples of providers and their costs:

• Hospital for Special Surgery (New York): Costs range from $25 to $300. Insured patients typically pay $20-$50 out-of-pocket if the injection is deemed medically necessary.
• Cleveland Clinic (Ohio): $294.53 for a corticosteroid injection. Insurance coverage and out-of-pocket costs may vary.

Efficiency: Corticosteroid injections can provide relief within 1-3 days, with effects lasting for several weeks to months. The procedure itself takes only a few minutes to perform.

Hydrodilatation

Hydrodilatation is a procedure used for more severe cases of frozen shoulder that haven't responded to other treatments.

The national average cost for hydrodilatation is approximately $350 (converted from £282). This procedure is significantly less expensive than surgical options. Insurance coverage for this procedure can vary, so it's important to check with your provider.

Examples of providers and their costs:

• London Shoulder Specialists (UK): £575 (approximately $715 USD)

Efficiency: The procedure takes about 1-2 hours, and patients typically experience improvement within 1-2 weeks. Full recovery and range of motion can take several weeks to months.

Manipulation Under Anesthesia

This procedure is typically reserved for severe cases that haven't responded to other treatments.

The national average cost for Manipulation Under Anesthesia is approximately $1,172.25. This cost can vary significantly based on the facility and geographic location. Insurance coverage for this procedure is common, but patients may still be responsible for copays, coinsurance, or deductibles.

Examples of providers and their costs:

• Advanced Pain Management (Multiple locations): $1,000 for shoulder MUA, with additional charges for the surgery center and anesthesiologist.

Efficiency: The procedure itself takes 1-2 hours, with patients typically staying in the hospital for a day. Recovery time can range from 1-2 weeks, with ongoing physical therapy for several weeks after.

Arthroscopic Capsular Release (Surgery)

This is typically the last resort for treating frozen shoulder when all other methods have failed.

The national average cost for shoulder arthroscopy, which includes arthroscopic capsular release, is $25,925, with a range of $6,900 to $31,650. This cost can vary significantly based on the facility, geographic location, and complexity of the procedure. Insurance typically covers a significant portion of this cost, but patients may still be responsible for copays, coinsurance, or deductibles.

Examples of providers and their costs:

• Hospital for Special Surgery (New York): Costs vary based on individual insurance plans. They offer a price estimator tool and Insurance Advisory Service for personalized estimates.

Efficiency: The surgery typically takes 1-2 hours, with patients usually going home the same day. Full recovery and return to normal activities can take 6-12 weeks, with ongoing physical therapy during this time.

Summary Table: Procedures

Remember, these costs are estimates and can vary significantly based on location, provider, and individual circumstances. Always consult with your healthcare provider and insurance company for the most accurate cost information for your specific situation.

Optimizing for Cost

When seeking the most cost-effective treatment for frozen shoulder (adhesive capsulitis of the shoulder), consider the following strategies for each severity level:

Mild Frozen Shoulder

1. Self-assessment and home care
   • Utilize online resources for self-diagnosis
   • Implement gentle stretching exercises found on reputable websites
   • Use over-the-counter pain relievers (generic brands) as needed
2. Virtual consultation if symptoms persist
   • Opt for telemedicine appointments to reduce costs
   • Follow prescribed at-home treatments and exercises

Moderate Frozen Shoulder

1. In-person primary care visit
   • Choose a primary care physician over a specialist for initial diagnosis
   • Request generic prescription medications when possible
2. Physical therapy
   • Ask about group therapy sessions or supervised gym programs
   • Learn exercises to continue at home, reducing the number of in-person sessions
3. Imaging
   • Start with X-rays before considering more expensive MRI scans

Severe Frozen Shoulder

1. Specialist consultation
   • Seek a referral from a primary care physician to potentially reduce specialist fees
   • Consider teaching hospitals or clinics for potentially lower-cost care
2. Treatment options
   • Explore corticosteroid injections before considering more invasive procedures
   • If surgery is necessary, investigate outpatient options to reduce hospital stay costs
3. Rehabilitation
   • Combine in-person physical therapy with a home exercise program
   • Utilize telemedicine for follow-up appointments when possible

General Cost-Saving Tips

• Compare prices for medications and medical supplies across different pharmacies and online retailers
• Check if your insurance offers preferred providers or facilities for lower out-of-pocket costs
• Inquire about payment plans or financial assistance programs for more expensive treatments
• Consider participating in clinical trials for access to new treatments at reduced or no cost

By following these cost-optimizing strategies, patients can manage their frozen shoulder treatment more affordably while still receiving appropriate care for their condition's severity level.

Optimizing for Efficiency

When time is of the essence, patients may prioritize the fastest path to recovery from frozen shoulder (adhesive capsulitis of the shoulder). Here are efficient strategies for each severity level:

Mild Cases

• Opt for a virtual doctor consultation for quick diagnosis
• Start with over-the-counter pain relievers immediately
• Begin a home exercise program as soon as possible
• Consider scheduling physical therapy sessions to accelerate progress

Moderate Cases

• Schedule an in-person doctor consultation within 1-2 days
• Undergo X-rays on the same day as the consultation
• Start prescription NSAIDs or muscle relaxants immediately
• Begin physical therapy within the first week
• Consider corticosteroid injections early in treatment for rapid pain relief

Severe Cases

• Seek an urgent referral to an orthopedic specialist
• Schedule MRI or ultrasound within 1-2 days of specialist consultation
• Start an aggressive physical therapy program immediately
• Consider early interventions such as hydrodilatation or manipulation under anesthesia if conservative treatments don't show quick improvement
• For cases with significant limitation, discuss the option of arthroscopic capsular release to potentially shorten overall recovery time

General Efficiency Tips

• Prioritize adherence to prescribed exercises and treatments
• Combine appointments where possible (e.g., consultation and imaging on the same day)
• Opt for treatments with faster onset of action, even if they may be more expensive
• Utilize telemedicine for follow-up appointments to save time
• Consider taking time off work or modifying activities to focus on intensive treatment and rehabilitation

By focusing on efficiency, patients can potentially reduce the overall duration of their frozen shoulder (adhesive capsulitis of the shoulder) symptoms and return to normal activities more quickly. However, it's important to note that even with the most efficient approach, recovery from frozen shoulder can take several months due to the nature of the condition.

Balancing Cost and Efficiency

When treating frozen shoulder (adhesive capsulitis of the shoulder), finding the right balance between cost and efficiency is crucial for optimal patient outcomes and satisfaction. Here are balanced approaches for each severity level:

Mild Cases

1. Diagnosis:
   • Start with self-assessment and virtual consultation
   • Cost: Low
   • Efficiency: High
2. Treatment:
   • Combine over-the-counter pain relievers with home exercises
   • Consult physical therapist for a one-time session to learn proper techniques
   • Cost: Moderate
   • Efficiency: Moderate to High

Moderate Cases

1. Diagnosis:
   • In-person doctor consultation with same-day X-rays
   • Cost: Moderate
   • Efficiency: High
2. Treatment:
   • Prescription NSAIDs (generic) combined with physical therapy
   • Consider a single corticosteroid injection if progress is slow
   • Cost: Moderate
   • Efficiency: Moderate to High

Severe Cases

1. Diagnosis:
   • In-person orthopedic specialist consultation with MRI
   • Cost: High
   • Efficiency: High
2. Treatment:
   • Intensive physical therapy combined with prescription pain management
   • Consider hydrodilatation if no improvement after 6-8 weeks
   • Reserve surgery for cases not responding to conservative treatments
   • Cost: High
   • Efficiency: Moderate

By tailoring the approach to each severity level, patients can achieve a balance between cost-effective care and efficient treatment. This strategy emphasizes early intervention and conservative management when appropriate, while reserving more costly and invasive procedures for cases that truly require them. Regular reassessment of progress is key to ensuring that the chosen approach remains both cost-effective and efficient throughout the treatment process.

Conclusion

Treating frozen shoulder (adhesive capsulitis of the shoulder) can vary significantly in both cost and time, depending on the severity of the condition and the chosen treatment approach. This comprehensive guide has outlined the various aspects of diagnosis and treatment, from self-assessment to surgical interventions, providing readers with a clear understanding of what to expect in terms of expenses and time commitments.

Key takeaways include:

1. Early diagnosis and treatment can lead to more cost-effective outcomes and faster recovery times.
2. The severity of frozen shoulder greatly influences the treatment path and associated costs.
3. A range of treatment options exists, from low-cost over-the-counter medications to more expensive surgical procedures.
4. Balancing cost and efficiency often involves a combination of at-home care, professional medical treatment, and patience.
5. Insurance coverage can significantly impact out-of-pocket expenses, so it's essential to understand your policy and explore all available options.

By understanding the various treatment options and their associated costs, patients can work with their healthcare providers to develop a treatment plan that best suits their medical needs, financial situation, and time constraints. Remember that while cost is an important factor, the primary goal should always be to achieve the best possible outcome for long-term shoulder health and overall well-being.

Ultimately, the most effective approach to treating frozen shoulder is often a personalized one, taking into account individual circumstances and preferences. By being informed about the available options and their implications, patients can actively participate in their care decisions and navigate the treatment process with confidence.