Chronic pain can keep children from being social and active, leading to anxiety and depression, a child psychiatrist says. Unfortunately, this can turn into a vicious cycle -- worsening depression and anxiety can also worsen pain perception. Between 5% and 20% of children live with chronic pain. It usually takes the form of bone and muscle pain, headaches or abdominal pain. "Parents may feel helpless and frightened as they watch their children try to cope -- which can make them feel anxious and depressed, just when they need to be their child's biggest cheerleader," said Dr. Taranjeet Jolly. He is a psychiatrist at Penn State Health Milton S. Hershey Medical Centre in Harrisburg, Pa. But hope is not lost, he said. The first step is recognizing that a problem exists.

"Look for red flags that depression may be overwhelming your child. Often your first clue is a change in their everyday routine," Jolly said. "Is their sleep time way up or down? Is there a marked change in their social interaction? Maybe they are more irritable, angry or emotional." Talk to your child about what's going on and follow up with a pediatrician, he suggested. If he or she is diagnosed with depression, follow up with a child psychiatrist, he advised.

"The treatment varies according to the level of severity, but something called cognitive behavioural therapy can almost always help," Jolly said.

Cognitive behavioural therapy can teach pain-coping skills and how to apply them in different situations. Medication -- such as nonsteroidal anti-inflammatory drugs (NSAIDs, like ibuprofen) and antidepressants -- may also be helpful. Overall, Jolly encourages parents to take an active role in promoting their child's well-being. "It's a team game where the goal is to help your child stop thinking about the pain, and gain as much functionality as possible," Jolly said. "As with all challenges in life, some days are better than others, but always trying is the key."

Opioids are no better than other meds at quelling the pain of a pulled tooth, a new study finds, suggesting it may be possible to significantly reduce their use in dentistry. University of Michigan researchers asked more than 325 people who had teeth pulled to rate their pain and satisfaction within six months of their extraction.

About half of those who had surgical extraction and 39% of those who had routine extraction were prescribed opioids, according to the study.

"Patient satisfaction with pain management was no different between the opioid group and non-opioid group, and it didn't make a difference whether it was surgical or routine extraction," study co-author Dr. Romesh Nalliah said in a university news release. He is associate dean for patient services at Michigan's School of Dentistry. In fact, his team was surprised to find that patients who got opioids reported worse pain than those given non-opioid painkillers for both types of extractions. The study also found that about half of the opioids prescribed went unused.

If leftovers are not disposed of properly, patients or people around them could be at risk of future opioid misuse, the researchers noted.

"The real-world data from this study reinforces the previously published randomized-controlled trials showing opioids are no better than acetaminophen and nonsteroidal anti-inflammatory drugs for pain after dental extraction," said study co-author Dr. Chad Brummett.

 HealthDay