Thursday, 13 May 2010

Popping Pills

Yesterday a man in his 60's came to see me with knee pain. He had a diagnosis of osteoarthritis, or in other words, wear and tear of his joints. He knew that the condition could only be treated symptomatically. He knew that there was no way of reversing the process and no real cure apart from replacing the joint. He had always refused, however, to take any painkillers, claiming that he believed in the body's innate ability to heal itself. Now he wanted a referral to the surgeons for joint replacement.

It struck me as really odd that this man would prefer surgery to taking tablets, but he's not alone. There seems to be an ever increasing proportion of patients who don't like the idea of taking medication. Whilst they're often happy to consume vast quantities of echinacea, arnica and all number of unknown 'supplements', be poked and prodded by tiny needles or pay a fortune to be put into a trance, the idea of taking conventional medicine is akin to ingesting poison.

Despite what you may be thinking, I am not a pill pusher. Indeed I am completely in favour of taking as few medications as possible, as infrequently as possible. Nonetheless I do find it hard to understand this deep mistrust of conventional medicine. Why do so many believe in therapies which often have little scientific basis and almost always no real evidence behind them, whilst those treatments tried and tested under the most rigorous conditions are somehow feared.

There is also a belief, I think, that conventional or 'Western' medicine is in some way unnatural when compared to the complimentary therapies. A feeling that the medications are artificial and as a result could damage the body. Yet huge numbers of our most commonly used medicines are sourced from natural products: penicillin from a fungus, morphine from poppies, digoxin from the foxglove, aspirin from the bark of a willow tree.

So what's the big problem with conventional medicine?


  1. Well he's right and he's wrong. Surgery is a way but not one I would recommend as results are not as good as they are alleged. Painkillers especially NSAID's have a number of side effects that are quite extensive in the older patient cohort especially if used in the long term. Supplements; well there is extensive empirical evidence that Omega 3's especially EPA have a profound effect on reducing pain or even eliminating it, as does physiotherapy targeted at the muscle group around the knee. Anecdotally I can vouch for both, having both knees considerably compromised by OA. There is some evidence for chondroitin as helping rebuild cartilage, so I would try these for some time before considering surgery, which has considerable risks attached.
    As for the reluctance to use medication generally; you would be right. Big Pharma has an apalling reputation for slanted and untruthfull studies that promote it's products and people are waking up to the notion that lifestyle modification sometimes supported by supplement, is a far better way of treating many ailments than is the treating of the symptom only, especially those of hypertension, where smoking cessation, exercise and a low carbohydrate diet work miracles, but take a few months to bear fruit.
    I'm a sceptic as regards many herbs and supplements or vitamins/minerals are concerned but I'm also a staunch advocate of CoQu10 supplementation for anyone over 50. The same with Vit D3 in the winter months when we have no sunlight, so remain pragmatic. And yes you are right that many drugs were originally derived fron herbs and plants, but they are now synthetic derivatives. You are still better off with the original white willow bark extract than aspirin, due to the lack of GI consequences with the former. However I would not advocate using red rice yeast or the statin it has become due to the consequences of both being the same, for an altogether flawed hypothesis. Pragamtism and disregard for QOF's is the key to treating people not symptoms. Too much of modern medicine is steeped in dogma rather than science, 'real science' that is.

  2. I think some people feel, perhaps subconsciously, that if they take regular medication, it's an admission of defeat or an admission that they are 'ill' or getting old.