Medication is not always the best treatment and prevention is better

ACCORDING to a survey that hit the headlines in 2013, half of women and 43 per cent of men in England regularly take prescription medication.

A more recent statistic showed that, on average, 18.6 items were prescribed in primary care for each patient registered with a GP in England.

That may or may not surprise you. You may think this is too much or perhaps you may think it is just about right. Regardless, there are certainly those among us who need these medications.

Controlling blood pressure, relieving pain and lowering cholesterol are all vital ways in which we can maintain and improve the health of our population. Medications are undeniably integral to this.

But what if we didn’t have the luxury of pharmaceuticals? After all, it wasn’t so long ago that we endured the pain of surgery without anaesthesia or tried to control infections and other miscellaneous diseases with the practice of bloodletting.

Medication, though important, is not the be all and end all and there are lots of conditions that can be treated or even prevented by other means.

A swollen sprained ankle in the absence of painkillers, for example, will benefit from the simple application of some ice.

Although there is not too much evidence that the cold helps long-term rehabilitation for soft tissue injuries, it certainly reduces inflammation and reduces discomfort. The cold sensation also slows down the conduction of nerve pathways, thereby further reducing pain.

Likewise, olive oil in the ears will loosen wax and prevent it from building up (remember never use cotton buds to clear your ears) and pumice stone will get rid of hard skin and corns that might otherwise begin to cause pain.

According to the World Health Organisaion, around 80 per cent of the world’s population still use traditional home remedies, including plants, in order to meet their health needs.

This is not too surprising when one considers that most of our modern medicines are derived from the natural world anyway.

One of the precursors to aspirin, for example, is found in willow bark and has been used as an anti-inflammatory for at least a thousand years and many of our antibiotics are developed from products isolated from fungi and bacteria.

It is inevitable then that, over the centuries, we have developed a huge number of myths and legends, often told in old wives’ tales, about how we should enhance our health.

Ginger, for instance, was used by 17th century soldiers in their wine in the belief that it would protect them from plague. It is also thought by many to help with joint pain, headaches and nausea. Garlic is meant to have antibacterial properties.

Unfortunately, as much as some people swear by these things, not all of them have the benefit of a lot of evidence.

In general, herbal remedies are not recommended as treatments by the NHS. As well as the lack of evidence, the herbal remedy market is significantly unregulated compared with the pharmaceutical industry.

This means that there is always the potential that things will be marketed in misleading ways and can easily miss out various ingredients in the packaging. The internet market for such treatments has exaggerated this issue.

Having said that, there might be at least some basis for the use of certain things. Echinacea is often cited as something to help with colds. This is the typical story that might be passed on through the family and perpetuated with each generation but a 2012 study showed that while there was some small evidence that it might relieve symptoms it cannot prevent a cold.

Lemon balm is found by many health professionals to be an effective and legitimate way to treat things like cold sores, at least from the point of view of soothing any discomfort.

Furthermore, if you’re stuck in the woods and have a nasty cut, things like yarrow will anecdotally be a reasonable thing to grind up and apply.

The plant is from the genus achillea, purportedly inspired by the legend of Achilles who was said to have carried yarrow with him to treat his war wounds. If you are unlucky enough to experience a bout of diarrhoea while you’re out there, apparently blackberry leaf tea can be helpful.

Generally, however, I would advise avoiding any remedies that you have to ingest, certainly if you take other medications that might interact or if you are about to have surgery (interactions with anaesthetics have been known). Ones that you apply to your skin may not do you any harm, although sometimes reactions can occur, but they may not be significantly effective other than depleting your wallet or purse.

Even aloe vera, which seems to be included in every cream these days, doesn’t have a good body of evidence behind its reported wound-healing properties.

How to keep your skin healthy otherwise then? First and foremost, avoiding the damage that the sun can deal out is your priority. For the purposes of this article, sun cream is cheating as it is a pharmaceutical of sorts, so wear hats and sit in the shade (but wear sun cream too).

Using fragrant and fancy soaps, particularly if you are washing frequently can damage the skin also. In infants and babies, bubble bathes can contribute to itchy vaginitis and itchy bottoms, so avoid these if you can and it is important at any age to moisturise your skin with a greasy emollient. It doesn’t necessarily have to have any special ingredients in it.

In some conditions, like psoriasis (a scaly skin condition similar to eczema that can be quite severe), sun light exposure can actually be therapeutic. Coal tar, which was ingested historically as an anti-inflammatory and pain reliever before it became clear it had carcinogenic properties, is still use topically (on the skin) for some case of psoriasis too.

And if you are stung by a nettle, unfortunately there is no evidence to support the old wives’ tale that dock leaves will help. Much better to use soap, milk or some diluted sodium bicarbonate for their alkaline properties.

Despite all of the above, prevention is, of course, better than cure (a quote that has been around in various forms as far back as 1240 — “An ounce of prevention is worth a pound of cure”) and is most certainly a non-pharmaceutical intervention. The greatest of them all in fact.

Exercise, diet and lifestyle are the key non-medicinal treatments we should all be using. As many have said before, if exercise could be taken as a pill, it would be better than any tablets we have now.

Two-and-a-half hours of exercise a week at least, alongside a non-sedentary lifestyle, will reduce your risk of dementia and depression by 30 per cent, your risk of cardiovascular disease and stroke by 35 per cent and your risk of colon cancer and type 2 diabetes by 50 per cent.

Eat a balanced diet and avoid too much refined sugars and saturated fat. Eat a variety of foods to get the best sources of minerals and vitamins.

You can’t exist solely on carrots as good a source of vitamin A for your vision, for example (and if you do you may experience an oranging of the skin known as carotenosis).

And finally, as always, keep your alcohol intake to within 14 units a week at the very most and stop smoking.

Medications have a big part to play in our lives but as we begin to take more and more of them, they begin to cause problems of their own.

There is a scenario in which, if absolutely everyone followed a healthy and active lifestyle, the pharmacists would be twiddling their thumbs and a prescription for something would become an occasional rarity. However absurd that may sound, wouldn’t it be nice?

• Next time: Pandemics.