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 |  | With Health Insurance: Copay + 10%-50% Coinsurance |  | Without Health Insurance: $500-$90,000+ |
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Neuropathy is damage to or dysfunction of a nerve or group of nerves. Possible causes include injury or a system-wide problem such as diabetes or HIV infection. Symptoms can include pain, a loss of feeling in the affected area, tingling sensations, muscle weakness and paralysis.
Typical costs: | - For patients covered by health insurance, out-of-pocket costs typically consist of doctor visit copays, prescription drug copays and copays or coinsurance of 10%-50%. Treatment for neuropathy typically is covered by insurance.
- For patients not covered by health insurance, treatment for neuropathy can cost less than $500 for over-the-counter or prescription pain reliever or a corticosteroid injection done in a doctor's office; it can cost $50-$350 per session -- or a total of hundreds or thousands of dollars -- for physical therapy; it can cost $1,000-$5,000 or more per year for epidural steroid injections, or for anticonvulsant medications prescribed to treat nerve pain. Surgery can cost $20,000-$90,000 or more, depending on the facility and the type of surgery.
- For example, Drugstore.com charges about $10-$12 for a one-month supply of a generic tricyclic antidepressant such as nortriptyline[1] or amitripyline, which have been shown to relieve nerve pain in some patients. Drugstore.com charges about $20-$100 or more, depending on dose, for a one-month supply of the generic drug gabapentin[2] , an anticonvulsant also used to treat neurological pain, and charges about $70-$400 or more, depending on dose, for the brand-name equivalent, Neurontin[3] . Drugstore.com charges about $100-$250 or more for a one-month supply of the anticonvulsant medication Lyrica[4] , also used for neurological pain. Physical therapy typically costs from $50-$350 per session. According to Medscape.com[5] , an epidural steroid injection for spinal stenosis typically costs about $2,200.
- Dartmouth-Hitchcock Medical Center[6] charges about $7,600, after a 30% uninsured discount, for a carpal tunnel release surgery.Saint Elizabeth Regional Medical Center[7] charges about $12,000-$16,000, not including doctor fee, for a laminotomy, a surgery that removes part of the lamina, the bony layer covering the spinal cord. Herniated disc surgery costs $20,000-$50,000 or more. And a laminectomy, which removes the lamina completely, typically costs $50,000-$90,000.
Related articles: Back Surgery, Carpal Tunnel Treatment, Herniated Disc Surgery, Physical Therapy
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What should be included: | - Treatment for neuropathy depends on the individual case, symptoms, severity and underlying cause. Nerve pain and other symptoms can be treated with non-steroidal anti-inflammatory medication. Or, a doctor might prescribe tricyclic antidepressants[8] or anticonvulsant medications such as gabapentin[9] (brand name Neurontin) or pregabalin[10] (brand name Lyrica). If the neuropathy is caused by a spinal problem such as a herniated disc, the doctor might recommend epidural steroid injections[11] , which provide significant relief for at least 50% of patients and typically need to be repeated at least once per year.
- In severe cases, nerve decompression surgery such as carpal tunnel release[12] , a diskectomy[13] or a laminectomy[14] might be recommended. It is important that underlying causes such as diabetic neuropathy[15] , HIV neuropathy[16] and nutritional neuropathy[17] be treated to reduce or relieve neuropathy symptoms. The National Institute of Neurological Disorders and Stroke offers an overview[18] of peripheral neuropathy and treatment.
Additional costs: | - Some patients require a cane, which typically costs about $15-$80, or a walker, which can cost up to $200 or more.
Discounts: | - Many hospitals, doctors and physical therapists give discounts of up to 30% or more to uninsured/cash-paying patients. For example, Washington Hospital Healthcare System[19] in California offers a 35% discount. And ARC Physical Therapy[20] in Illinois offers a 30% discount to cash-paying patients, as well as special waivers or discounts for patients experiencing financial hardship.
- Some drug manufacturers offer patient assistance programs. Any patient without prescription drug coverage who also is not eligible for Medicare typically qualifies for the Together Rx Access[21] , a discount card that offers 25%-40% off brand-name drugs from many pharmaceutical companies. Most companies also offer free drugs to patients who have no coverage and meet certain criteria.
Shopping for neuropathy treatment: | - A family doctor can provide a referral to a neurologist or, if surgery is necessary, a neurosurgeon or orthopaedic surgeon, depending on the location and cause of the neuropathy and the type of surgery needed. Or, the American Academy of Neurology offers a neurologist locator[22] . The American Board of Neurological Surgery offers a neurosurgeon locator[23] . And the American Board of Orthopaedic Surgery offers an orthopaedic-surgeon finder[24] by city, state or zip code. Both orthopaedic surgeons and neurosurgeons can perform surgery on the spine. SpineUniverse.com[25] , a site run by orthopaedic surgeons and neurosurgeons, offers advice on choosing between an orthopaedic surgeon and a neurosurgeon.
- The American Physical Therapy Association offers a physical-therapist locator.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - www.drugstore.com/nortriptyline-hcl/pamelor/10mg-capsules/qxn00591578601
- www.drugstore.com/gabapentin/qxdgabapentin
- www.drugstore.com/neurontin/qxdneurontin
- www.drugstore.com/lyrica/qxdlyrica
- www.medscape.com/viewarticle/552376
- patients.dartmouth-hitchcock.org/billing_questions/out_of_pocket_estimator_dhmc.ht...
- tp.chi.acelogicus.net/nese/Default.aspx
- www.medscape.com/viewarticle/409782_2
- www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000940/
- www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000327/
- www.spine-health.com/treatment/injections/lumbar-epidural-steroid-injections-low-b...
- www.nlm.nih.gov/medlineplus/ency/article/002976.htm
- www.nlm.nih.gov/medlineplus/ency/article/007250.htm
- www.mayoclinic.com/health/laminectomy/MY00674
- diabetes.niddk.nih.gov/DM/pubs/neuropathies/
- www.hopkinsmedicine.org/neurology_neurosurgery/conditions_main/old/hiv_neuropathy....
- peripheralneuropathycenter.uchicago.edu/learnaboutpn/typesofpn/systemic/nutrition....
- www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
- www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/
- arcphysicaltherapy.com/cost-insurance/
- www.togetherrxaccess.com/p/prescription-savings/about-together-rx-access/enroll.aspx
- patients.aan.com/findaneurologist/
- www.abns.org/diplomates/default.aspx
- www.abos.org/find-a-certified-orthopaedic-surgeon.aspx
- www.spineuniverse.com/treatments/surgery/neurosurgeon-or-orthopedic-surgeon-does-m...
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