Alternative & Integrative Health Archive

By Anne Fabiny, M.D., Editor in Chief

President Barack Obama recently announced the Precision Medicine Initiative, a new program to speed up discoveries based on information and technology stemming from the Human Genome Project. "Precision medicine" and "personalized medicine" are terms that describe health care tailored to an individual patient's genetic makeup, using information about a patient's genome to diagnose illness and design therapies to treat and cure disease. This approach has been described as "the medicine of the future."

However, it may be reassuring to know that although your doctor doesn't have your genome at hand, he or she is likely to be giving you personalized care as we understand it today.

For many people with rheumatoid arthritis, medication can help relieve symptoms and even limit joint damage. But nondrug approaches, such as physical and occupational therapy, are also essential to help reduce pain, improve range of motion, increase strength, and protect joints.

Specially trained clinicians can provide these nondrug treatments. Your primary care doctor or rheumatologist may refer you to a physiatrist, physical therapist, or occupational therapist, for example.

Q. I have developed bunions, making it impossible to wear most of my shoes without pain. Is there anything I can do to help the problem without undergoing surgery?

A. There are several things that can be done for bunions, which develop when the first metatarsal bone of the foot turns outward and the big toe points inward (toward the other toes), causing the joint to bulge outward. A podiatrist would be able to suggest ways to relieve your pain and prevent your bunions from getting worse. He or she will likely recommend different types of shoes, especially if you've been wearing shoes with pointed toes, high heels, or both. Podiatrists often prescribe custom-fitted padded inserts, known as orthotics, that are worn inside your shoes to help relieve pressure on your bunions. Surgery is usually a last resort, but your podiatrist will also be able to discuss the risks and benefits of different types of bunion surgery.

It can reduce discomfort and get you back on your feet faster.

For anyone who has been constipated, the promise of relief through medication is clouded by the possibility of developing a "laxative habit." However, a study published online Nov. 18, 2014, by the Journal of General Internal Medicine offers a drug-free approach to the problem: applying pressure to the perineum (the area between the genitals and the anus).

Researchers from the University of California, Los Angeles, studied 100 women and men with chronic constipation. Half were randomly assigned to receive handouts describing conventional approaches to relieving constipation, such as increasing fluid and fiber intake, getting regular exercise, and using laxatives and other medications. The other half got the same handouts, and were also instructed to use their index and middle fingers to press on the perineum at the first urge to defecate and continue until the stool passed easily.