What is the cost of treating tennis elbow?

Severity Levels of Tennis Elbow (Lateral Epicondylitis)

Tennis elbow (lateral epicondylitis) can present with varying degrees of severity, each requiring different approaches to diagnosis and treatment. Understanding these severity levels can help patients and healthcare providers determine the most appropriate course of action.

Mild

Mild cases of tennis elbow are often characterized by occasional pain during activities that involve the affected arm. This level of severity is typically associated with repetitive arm movements, such as those performed in racquet sports or certain occupations.

• Symptoms: Occasional pain during activity
• Risk factors: Repetitive arm movements
• Diagnosis: Self-diagnosis or virtual doctor consultation
• Imaging/labs: Generally not required
• Treatments: Rest, ice, over-the-counter pain relievers

For mild cases, conservative home treatments are often sufficient, and professional medical intervention may not be necessary.

Moderate

Moderate tennis elbow presents with more persistent pain and a noticeable weakening of grip strength. This severity level is often seen in individuals who engage in prolonged repetitive movements or those in the 30-50 age range.

• Symptoms: Persistent pain, weakened grip strength
• Risk factors: Prolonged repetitive movements, age (30-50)
• Diagnosis: In-person doctor visit
• Imaging/labs: Possible X-ray or ultrasound
• Treatments: Physical therapy, bracing, anti-inflammatory medications

At this stage, professional medical advice is recommended, and more targeted treatments may be necessary to manage symptoms and prevent progression.

Severe

Severe cases of tennis elbow involve chronic pain and significant loss of function in the affected arm. This level of severity is often associated with occupational hazards or sports injuries.

• Symptoms: Chronic pain, significant loss of function
• Risk factors: Occupational hazards, sports injuries
• Diagnosis: Specialist consultation
• Imaging/labs: MRI, nerve conduction studies
• Treatments: Corticosteroid injections, surgery (in rare cases)

Severe tennis elbow requires comprehensive medical intervention, including specialist consultation and potentially more invasive treatments.

Summary Table: Severity Levels

Getting a Diagnosis

Getting an accurate diagnosis is the crucial first step in treating tennis elbow (lateral epicondylitis). The method you choose can significantly impact both the cost and efficiency of your treatment. Let's explore the various options available:

Self-diagnosis

• Cost: $0
• Time: Immediate
• Appropriate for: Mild cases

Self-diagnosis is the most cost-effective option but should only be considered for mild cases with typical symptoms. While it costs nothing, it carries the risk of misdiagnosis and delayed treatment if the condition is more severe than anticipated.

Virtual doctor consultation

1. Teladoc
   • General Medical Visits:
     • Without insurance: $89 per visit
     • With insurance: $0 per visit (based on your benefits)
   • Therapy Visits:
     • Without insurance: $99 per session
     • With insurance: $0-$99 per session
   • Psychiatry Visits:
     • Without insurance:
     • First-time visit: $299
     • Follow-up visits: $119
     • With insurance:
     • First-time visit: $0-$299
     • Follow-up visits: $0-$129
2. MDLive
   • 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:
     • Initial session: $248
     • Follow-up sessions: $108
3. OptimalMD
   • Cost: Free with OptimalMD membership ($47/month for the entire family)
   • Time: Same-day availability, typically within 15-30 minutes

Virtual consultations offer a convenient and often cost-effective way to get a diagnosis for mild to moderate cases of tennis elbow. They're especially useful for initial assessments and follow-up appointments.

In-person doctor visit

1. Primary Care Physician (PCP)
   • Cost without insurance: $150 to $300 (average $171)
   • Cost with insurance: Typically a copay of $20-$50
2. Urgent Care Center
   • Cost without insurance: $100 to $150
   • Cost with insurance: Typically a copay of $50-$100
3. OptimalMD
   • Cost: Heavily discounted with OptimalMD membership
   • Time: Typically 1-3 days wait time, 30-60 minutes for the appointment

In-person doctor visits are recommended for moderate cases or when physical examination is necessary. They offer a more comprehensive assessment but may be more expensive and time-consuming than virtual options.

Specialist consultation

1. Orthopedic Specialist
   • Cost without insurance: $250-$509
   • Cost with insurance: Typically a copay of $30-$75
2. Sports Medicine Physician
   • Cost without insurance: $189-$349 (initial consultation)
   • Cost with insurance: Typically a copay of $30-$75
3. OptimalMD
   • Cost: Heavily discounted with OptimalMD membership
   • Time: Typically 1-2 weeks wait time, 30-60 minutes for the appointment

Specialist consultations are recommended for severe cases or when initial treatments haven't been effective. They provide expert diagnosis and treatment plans but are typically the most expensive option with longer wait times.

Summary Table: Assessment Options

This table provides a comprehensive overview of the diagnosis options for tennis elbow, considering factors such as appropriate severity levels, costs with and without insurance, and efficiency. It's important to note that actual costs may vary depending on location, specific insurance plans, and individual circumstances.

Imaging and Laboratory Tests

In the diagnosis and treatment of tennis elbow (lateral epicondylitis), various imaging and laboratory tests may be required depending on the severity of the condition. Here's an overview of the most common tests, their costs, and efficiency:

X-ray

X-rays are typically used to rule out other conditions that may cause similar symptoms, such as fractures or arthritis.

• Providers and Costs:
  • RadiologyInc: $260 - $460 without insurance
  • MedImagery: $200 - $400 without insurance
  • Free with OptimalMD membership
• Insurance Coverage: Most insurance plans cover X-rays, with patients typically responsible for a copay of $10 - $50
• Time: 15-30 minutes for the procedure, results usually available within 24 hours
• Appropriate for: Mild to moderate cases to rule out other conditions

Ultrasound

Ultrasound can help visualize soft tissue damage and inflammation associated with tennis elbow.

• Providers and Costs:
  • UltraSoundNow: Starting at $250 for full imaging and doctor's report
  • SonoClinic: $200 - $300 without insurance
  • Heavily discounted with OptimalMD membership
• Insurance Coverage: Many insurance plans cover ultrasounds, with patients typically responsible for a copay of $20 - $100
• Time: 30-45 minutes, results often immediate
• Appropriate for: Moderate cases to assess soft tissue damage

MRI

MRI provides detailed images of soft tissues and can help diagnose severe cases or when surgery is being considered.

• Providers and Costs:
  • MRIServices: $1,050 - $7,000 for upper extremity MRI without insurance
  • AdvancedImaging: $900 - $6,000 for upper extremity MRI without insurance
  • Heavily discounted with OptimalMD membership
• Insurance Coverage: Most insurance plans cover MRIs with a doctor's referral, with patients typically responsible for a copay of $50 - $500
• Time: 30-60 minutes for the procedure, results usually available in 1-3 days
• Appropriate for: Severe cases or when surgery is being considered

Nerve Conduction Studies

These studies can help determine if there is nerve compression contributing to the symptoms of tennis elbow.

• Providers and Costs:
  • NerveStudies: $161 - $881 for 7-8 nerves study without insurance
  • NeuroCheck: $150 - $800 for a comprehensive study without insurance
  • Heavily discounted with OptimalMD membership
• Insurance Coverage: Many insurance plans cover nerve conduction studies with a doctor's referral, with patients typically responsible for a copay of $50 - $200
• Time: 30-60 minutes, results often immediate
• Appropriate for: Moderate to severe cases, especially when nerve involvement is suspected

It's important to note that while OptimalMD offers free or heavily discounted services, there is a monthly membership fee of $47 for the entire family. This can be a cost-effective option for those requiring multiple tests or ongoing care.

When considering these tests, it's crucial to consult with your healthcare provider to determine which tests are necessary for your specific condition. The severity of your tennis elbow, your overall health, and your healthcare provider's recommendations should guide your decision-making process.

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 tennis elbow (lateral epicondylitis), especially for moderate to severe cases. The most commonly prescribed medications fall into two main categories: oral NSAIDs and topical NSAIDs. In some cases, corticosteroid injections may also be recommended. Let's explore these options in detail:

Oral NSAIDs (e.g., Celecoxib/Celebrex, generic options)

Oral NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are often the first-line prescription treatment for tennis elbow. They help reduce pain and inflammation.

1. Celecoxib (brand name: Celebrex)
   • Cash price: $59.07 for 30 capsules (200mg)
   • With insurance: Copay typically ranges from $10 to $50
   • With discount card: As low as $8.81 with SingleCare coupon
   • Free with OptimalMD membership
2. Generic Celecoxib
   • Cash price: $18.43 for 14 capsules (200mg)
   • With insurance: Copay typically ranges from $5 to $30
   • With discount card: Prices can be as low as $4 for a 30-day supply
   • Free with OptimalMD membership

Time: Immediate relief, 1-2 weeks for full effect

Topical NSAIDs (e.g., Diclofenac/Voltaren, generic options)

Topical NSAIDs are applied directly to the skin over the affected area, providing localized pain relief with fewer systemic side effects compared to oral NSAIDs.

1. Diclofenac gel (brand name: Voltaren)
   • Cash price: $13 for a 100-gram tube
   • With insurance: Copay typically ranges from $10 to $60
   • With discount card: As low as $7 with SingleCare
   • Free with OptimalMD membership
2. Generic Diclofenac gel
   • Cash price: $13.09 for a 100-gram tube (1% concentration)
   • With insurance: Copay typically ranges from $5 to $40
   • With discount card: Prices can be as low as $7 for a 100-gram tube
   • Free with OptimalMD membership

Time: Immediate relief, 1-2 weeks for full effect

Corticosteroid injections

Corticosteroid injections are sometimes used for more severe cases of tennis elbow that don't respond to other treatments.

• Cash price: $100 to $300 per injection
• With insurance: Copay typically ranges from $20 to $100
• Heavily discounted with OptimalMD membership

Time: Immediate relief, effects last 6-12 weeks

It's important to note that while these medications can provide significant relief, they should be used under the guidance of a healthcare professional. Your doctor will consider your specific condition, medical history, and potential side effects when prescribing these medications.

Summary Table: Prescription Medications

Note: All prescription medications listed are free or heavily discounted with OptimalMD membership at $47 per month for the entire family.

Over-the-Counter Treatments

Over-the-counter (OTC) treatments are often the first line of defense for managing tennis elbow (lateral epicondylitis), especially in mild to moderate cases. These treatments are readily available without a prescription and can provide significant relief. Let's explore the various OTC options, their costs, and effectiveness.

Oral pain relievers (e.g., Ibuprofen, Naproxen)

Oral NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are commonly used to reduce pain and inflammation associated with tennis elbow.

1. Ibuprofen (e.g., Advil, Motrin)

• National average price (generic): Approximately $0.10 to $0.20 per tablet
• Brand name (Advil): Around $0.12 per tablet
• Cash price examples:
  • Walmart: $1.98 for 100 tablets (200mg)
  • Rite Aid: $1.99 for 100 tablets (200mg)
  • Walgreens: $5.99 for 100 tablets (200mg)
  • CVS: $8.49 for 100 tablets (200mg)

1. Naproxen (e.g., Aleve)

• National average price (generic): Approximately $0.50 to $1 per tablet
• Brand name (Aleve): Around $0.30 to $0.40 per tablet
• Cash price examples:
  • Generic: $11 for 4 tablets (500mg)
  • Generic delayed release: $51.14 for 100 tablets (375mg)

Insurance typically doesn't cover OTC medications, but some flexible spending accounts (FSAs) or health savings accounts (HSAs) may allow you to use pre-tax dollars for these purchases.

Time for relief: Both ibuprofen and naproxen typically provide initial relief within 20-30 minutes, with full effect in about 2 hours. They can be taken as needed, following package instructions.

Topical pain relievers (e.g., Bengay, Icy Hot)

Topical pain relievers can provide localized relief for tennis elbow pain.

1. Bengay

• National average price: $7.50 to $11 for a 4 oz tube
• Cash price examples:
  • Target: $7.59 (4 oz)
  • Walgreens: $10.99 (4 oz)

1. Icy Hot

• National average price: $7 to $11 for a 2-3 oz tube or applicator
• Cash price examples:
  • Amazon: $7.76 (2 oz Advanced Cream)
  • Walmart: $14.01 (2 oz Advanced Cream)
  • CVS: $10.29 (2 oz Advanced Cream)
  • Target: $6.99 (2.5 oz No Mess Applicator)
  • Walgreens: $9.99 (2 oz Advanced Muscle & Joint Pain Relief Cream)

As these are OTC products, they are typically not covered by insurance. However, some FSAs or HSAs may allow their purchase with pre-tax dollars.

Time for relief: Topical pain relievers usually provide a cooling or warming sensation within 5-10 minutes of application, with pain relief lasting for several hours.

Tennis elbow strap or brace

Tennis elbow straps or braces provide support and can help alleviate pain during activities.

• National average price: $10 to $20 for a basic tennis elbow strap or brace
• Cash price examples from Amazon:
  • Low-end: $5.97 (MOONSMILE Tennis Elbow Braces, 1 Pair)
  • Mid-range: $12.99 (Bracoo Tennis Elbow Brace)
  • High-end: $44.99 (Incrediwear Elbow Sleeve)

Tennis elbow straps and braces are generally not covered by insurance, but some FSAs or HSAs may allow their purchase.

Time for relief: Immediate support upon wearing, but it may take a few days of consistent use to notice significant pain relief.

Summary Table: OTCs

Note: While insurance typically doesn't cover OTC treatments, some FSAs or HSAs may allow for pre-tax purchases of these items. Always consult with a healthcare professional for personalized advice on managing tennis elbow.

Procedures

Tennis elbow (lateral epicondylitis) treatment often involves various procedures, depending on the severity of the condition. Here are the main procedures used in treating tennis elbow, along with their costs and time estimates:

Physical Therapy

Physical therapy is often the first-line treatment for moderate to severe cases of tennis elbow. Let's look at the costs and providers:

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

Here are some examples of physical therapy providers and their costs:

• ATI Physical Therapy (Multiple locations across the USA)
  • Without insurance: Up to $350 per session
  • Average cost without insurance: $150 per session
  • Self-pay rate: $113 per session
• FYZICAL Therapy & Balance Centers (Multiple locations across the USA)
  • Initial Evaluation/Treatment:
  • With insurance: $20 to $60 out-of-pocket
  • Without insurance: $50 to $150
  • Daily Visits:
  • With insurance: $20 to $60 out-of-pocket
  • Without insurance: $50 to $155
  • Cash pay options:
  • 15-minute session: $30
  • 30-minute session: $60

Typically, a course of physical therapy for tennis elbow lasts 6-12 weeks, with 2-3 sessions per week. Each session usually lasts 30-60 minutes.

Extracorporeal Shock Wave Therapy (ESWT)

ESWT is a non-invasive procedure used for moderate to severe cases of tennis elbow that haven't responded to conservative treatments.

The national average cost for ESWT ranges from $250 to $450 per session. Most patients require 3-5 sessions over 3-5 weeks. Insurance coverage for ESWT varies, as some insurers consider it experimental for tennis elbow treatment.

Here are some examples of ESWT providers and their costs:

• OrthoWave (New York, NY)
  • All-inclusive package: $2,700 (typically includes 3-5 sessions)
• Boston Sports Medicine (Boston, MA)
  • Offers competitive direct-payment rates based on discounted insurance rates
  • Contact provider for specific pricing

Each ESWT session typically takes 10-15 minutes.

Surgery (for severe cases)

Surgery is generally considered a last resort for severe cases of tennis elbow that haven't responded to other treatments.

The national average cost for tennis elbow surgery is approximately $4,000. However, this can vary significantly depending on the specific procedure, location, and whether it's performed as an outpatient or inpatient procedure.

Here are some examples of surgical costs:

• Hospital for Special Surgery (New York, NY)
  • Estimated cost: $10,000 to $15,000 (based on general U.S. pricing)
• UCLA Health (Los Angeles, CA)
  • Cost varies; use Patient Estimates tool or contact Centralized Cash Pricing Unit for specific pricing

The surgery typically takes 1-2 hours, with a recovery period of 6-12 weeks before returning to normal activities.

Summary Table: Procedures

Here's a summary table of the procedures discussed:

Procedures for Tennis Elbow Treatment

This table provides a quick overview of the procedures, their appropriate severity levels, price ranges with and without insurance, and the efficiency in terms of treatment duration or recovery time.

Optimizing for Cost

When seeking the most cost-effective approach to treating tennis elbow (lateral epicondylitis), consider the following strategies for each severity level:

Mild Tennis Elbow

• Self-diagnosis and management when possible
• Use over-the-counter oral NSAIDs like generic ibuprofen
• Apply low-cost topical pain relievers
• Implement rest and ice therapy at home
• Purchase an affordable tennis elbow strap online

Moderate Tennis Elbow

• Opt for a virtual doctor consultation instead of an in-person visit
• Choose generic prescription medications when available
• Prioritize at-home exercises over extensive physical therapy sessions
• Consider a combination of OTC pain relievers and a tennis elbow brace

Severe Tennis Elbow

• Start with a primary care physician before seeing a specialist
• Compare costs of imaging centers for required tests (e.g., MRI)
• Explore non-surgical options thoroughly before considering surgery
• Inquire about payment plans or financial assistance programs for more expensive treatments

By focusing on these cost-saving measures, patients can significantly reduce their overall expenses while still receiving appropriate care for their tennis elbow condition. Remember that while cost is important, it should not compromise the quality of treatment or recovery outcomes.

Optimizing for Efficiency

When time is of the essence, optimizing the treatment of tennis elbow (lateral epicondylitis) for efficiency becomes crucial. Here are the most time-efficient strategies for each severity level:

Mild Cases:

1. Self-diagnosis or virtual consultation for quick assessment
2. Immediate implementation of RICE (Rest, Ice, Compression, Elevation) protocol
3. Over-the-counter oral NSAIDs for rapid pain relief
4. Use of a tennis elbow strap for immediate support during activities

Moderate Cases:

1. Virtual consultation followed by an in-person visit if necessary
2. Same-day X-ray or ultrasound for quick imaging results
3. Prescription of oral or topical NSAIDs for faster pain management
4. Immediate start of at-home exercises combined with physical therapy sessions

Severe Cases:

1. Direct referral to a specialist for prompt evaluation
2. Expedited MRI scheduling for comprehensive diagnosis
3. Corticosteroid injections for immediate pain relief
4. Fast-tracked physical therapy program with frequent sessions

By prioritizing speed and accessibility in the diagnosis and treatment process, patients can potentially reduce recovery time and quickly return to their normal activities. However, it's important to note that the most efficient approach may not always be the most cost-effective or provide the best long-term outcomes. Patients should work closely with their healthcare providers to determine the optimal balance between efficiency and overall treatment effectiveness.

Balancing Cost and Efficiency

When treating tennis elbow (lateral epicondylitis), finding the right balance between cost-effectiveness and efficient treatment is crucial. Here's a breakdown of balanced approaches for each severity level:

Mild Cases

• Start with self-diagnosis and over-the-counter treatments
• If symptoms persist after 2-3 weeks, consider a virtual doctor consultation
• Focus on home exercises and affordable bracing options
• Time frame: 2-4 weeks for improvement
• Estimated cost range: $50-$150

Moderate Cases

• Begin with an in-person doctor visit for accurate diagnosis
• Combine prescription NSAIDs (generic options) with physical therapy
• Consider ultrasound imaging if improvement is slow
• Time frame: 4-8 weeks for significant improvement
• Estimated cost range: $300-$800

Severe Cases

• Start with a specialist consultation and appropriate imaging (MRI or nerve conduction studies)
• Pursue a combination of corticosteroid injections and intensive physical therapy
• Consider extracorporeal shock wave therapy if conservative treatments fail
• Reserve surgery as a last resort for persistent cases
• Time frame: 8-16 weeks for improvement, longer if surgery is required
• Estimated cost range: $1,000-$5,000 (potentially higher with surgery)

By following these balanced approaches, patients can receive appropriate care while minimizing unnecessary expenses and treatment delays. It's important to note that individual cases may vary, and patients should always consult with their healthcare providers to determine the most suitable treatment plan for their specific situation.

Conclusion

The cost of treating tennis elbow (lateral epicondylitis) can vary significantly depending on the severity of the condition and the chosen treatment approach. This comprehensive guide has explored various aspects of diagnosis and treatment, from self-care methods to advanced medical procedures.

Key takeaways include:

1. Severity levels play a crucial role in determining the appropriate treatment path and associated costs.
2. Diagnosis options range from free self-diagnosis to specialist consultations, with varying costs and time investments.
3. Imaging and laboratory tests may be necessary for accurate diagnosis, especially in moderate to severe cases.
4. Treatment options include over-the-counter medications, prescription drugs, physical therapy, and in rare cases, surgical intervention.
5. Costs can be optimized by starting with conservative treatments and progressing to more advanced options only when necessary.
6. Efficiency in treatment can be achieved through early intervention and adherence to recommended therapies.
7. Balancing cost and efficiency often involves a combination of self-care, targeted medical interventions, and lifestyle modifications.

By understanding these factors, patients can work collaboratively with healthcare providers to develop a treatment plan that is both cost-effective and efficient. It's important to remember that early intervention and proper care can significantly reduce long-term costs and improve outcomes for those suffering from tennis elbow (lateral epicondylitis).

Ultimately, the most appropriate treatment approach will depend on individual circumstances, including the severity of the condition, personal health factors, and financial considerations. Consulting with a healthcare professional is always recommended to ensure the best possible care and management of tennis elbow (lateral epicondylitis).