You Don’t Have to Take a Pill

Medications have their dark side. Exercise, diet, and other changes can be alternatives, but could feel like a whole lot of hard work.

We’ve gotten used to taking pills for much that ails us, but these days, the medicine cabinet is looking like a rogues’ gallery. There’s been bad news about the painkiller rofecoxib (Vioxx), the diabetes drug rosiglitazone (Avandia), and, most recently, the cholesterol-lowering combination of ezetimibe and simvastatin (Vytorin). Problems with hormone therapy and antidepressants have also been bannered in headlines.

We don’t lack for alternatives. Plenty of research shows that exercise, diet, and other lifestyle changes are effective weapons against many chronic diseases. But there are more findings about preventing diseases with so-called lifestyle changes than there are about treating them. And you won’t find many head-to-head comparisons between the conventional drug treatments and the nondrug ones. Often it seems like the nonpharmacological approach doesn’t quite get its due. The long review papers on treatment choices typically squirrel it away in a small section, almost as an afterthought.

Inertia, reimbursement incentives, pharmaceutical companies — you can wag an accusing finger at all these. But let’s be honest: there’s also the wonderful convenience of taking a pill. It’s just so much easier than changing what we eat, mustering up the time and willpower to exercise, or fighting the uphill battle of weight loss. Doctors see this and, understandably, figure medication is a more dependable, and responsible, way of treating a disease. And the health care system, as currently configured, doesn’t do much to support a nondrug approach.

But for those wary of taking medications who want to take the road less traveled, here’s a brief overview of seven common conditions and approaches to managing them without medication or supplements.

Arthritis

If you’re heavy and the problem is arthritic knees, losing weight won’t make the arthritis go away, but there’s a good chance it will make it less painful — and that’s what most people care about. Research results published several years ago showed that combining some weight loss (5.7% of body weight) with moderate exercise will result in less pain and improved mobility for heavy people with arthritic knees. The same research group reported results in 2006 showing that a more intensive weight-loss program (8.7% of body weight) results in pain and function improvements in obese people (a body mass index of 30 or more). Even for those who aren’t heavy, exercise that doesn’t put “load” on the joints — swimming and bicycling are good examples — works to reduce pain. For walking, the right shoes can make a huge difference for people with arthritic knees. Researchers have shown that a padded heel can cut in half the force with which your foot hits the ground with each stride. A knee brace is another thing to try. It can realign the knee, taking pressure off the “compartment” of the joint that’s the most arthritic. Knee braces can be bulky and inconvenient, so getting people to wear them is a problem. Activity that targets certain muscle groups is a proven pain reliever; beleaguered knees respond well to stronger quadriceps, for example. Some rain on the exercise parade: exercise may be more beneficial — and practical — for people with relatively mild cases of arthritis.