Health: Vital Signs

Hope for back pain sufferers who fear their condition will worsen as they grow older comes from the Pain Research Institute, the Liverpool- based charity. Evidence shows that most will either stay the same or improve with time and their chances of improving are higher if they practise pain management techniques. These are based on gentle exercise and relaxation combined with pain control.

According to Dr Chris Wells of the institute, those who suffer the least are the ones who exercise regularly making an effort to change their outlook and ignore the pain as much as possible. Pain control techniques and relaxation can be just as effective as pain killers in relieving the agony of a bad back.

`Coping with back pain', an audio tape produced by the Pain Research Institute (pounds 13.99 inc p&p), is available from Talking Life, PO Box 1, Wirral L47 7DD or tel: 0151 632 0662

Every year 350 children in the UK develop cancer of the brain or spinal cord. Desperate in their distress, some families appeal for money to send their children to the US for treatment believing that is their best hope.

An inquiry by the Royal College of Paediatrics has found that the expensive, highly publicised treatments are all available in NHS hospitals and that results are as good as anywhere in the world, with half the children likely to be cured.

The reasons why children are referred abroad are that NHS services are fragmented and doctors may not know where to send their patients. The report, "Guidance for services for children and young people with brain and spinal tumours", calls for a national network to treat children with brain cancer based on the 22 existing children's cancer centres.

A dying patient needs different care from one who is terminally ill. The last days of life are very important, with profound psychological as well as medical consequences. A new guide from the National Council for Hospice and Specialist Palliative Care Services says the care needed when death is imminent is so distinct from the previous palliative care that it resembles a gear change.

The guide warns that dying patients tolerate symptoms very poorly because of their weakness and debility and that their intensity can escalate rapidly to very severe distress if they are not controlled. "Treatments must be prescribed and administered regularly to control existing symptoms and to prevent new ones developing, and never withheld pending the results of investigations."

The British Dental Association is urging the Government to take stronger measures to support water fluoridation after a survey of MPs showed seven out of 10 supported adding fluoride to water supplies to prevent tooth decay. The survey follows recent figures showing decay was much more common in five-year-olds in non-fluoridated areas than in fluoridated ones.

The association says urgent action is necessary to make water suppliers comply with requests from health authorities: "Health Authorities and the BDA believe that water suppliers are misinterpreting the act and frustrating Parliament's original intention. Water fluoridation is the single most effective public health measure which health authorities can use to reduce tooth decay."