Chronic Pain After Burn Injuries: A Retrospective Review of Rate of Development of Chronic Pain After Thermal Injury and Investigation of Risk Factors

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-7-2026

Abstract

Burns are a major cause of morbidity and mortality across the world, with an impact that extends far beyond the reported 2.7% inpatient mortality rate. Disfigurement and chronic symptoms can have a significant impact on the long-term physical and psychosocial functions of survivors. Notably, the frequency of chronic post-burn pain is substantial but uncertain, with published rates ranging from less than 10% to over 80% of burn patients. While the general mechanisms of pain and factors associated with long-term outcomes have been established, very few studies explore management practices when treating these symptoms. This is significant, as chronic prescription pain medication use in this population correlates with substantially worse mental and physical outcomes. This study aims to characterize the long-term chronic pain outcomes and treatment strategies at our regional burn center.

This retrospective study evaluated all adult patients who were treated by the Burn service at Butterworth Hospital from January 1, 2024 to December 1, 2025. Qualifying patients were identified by a query of the institution's burn registry, and appropriate data from the registry was uploaded to a secure REDCap to ensure confidentiality. Additional data on medication use and outpatient courses was then supplied via direct Epic chart review by the research team. The primary objective was to determine the rate of chronic pain development among patients with acute thermal injuries. Secondary objectives included the determination of patient factors associated with the development of chronic pain, as well as characterization of the use of controlled substances for the treatment of symptoms. Descriptive statistics were then obtained. Numeric data was expressed as mean ± standard deviation, and categorical data was expressed as a frequency or percent.

203 patients met the criteria for inclusion. Inpatient mortality for the cohort was 5.9%. Among the 191 patients that were discharged as alive, 18 (9.4%) continued to require controlled substances after 60 days of follow up: 3 (1.6%) were taking just opioids, 12 (6.3%) were taking just gabapentin or pregabalin, and 3 (1.6%) required both opioids and gabapentin/pregabalin. Of these 18 patients, the average age was 57.7 years (SD ± 17.2), 61.1% were male, and 88.9% were white. The average total body surface area affected was 10.4% (SD ± 9.8%), with full-thickness defects accounting for 3.1% (SD ± 3.1%). The most affected anatomic regions were the bilateral lower legs, which were each burned in 10 of 18 (55.6%) patients. Additionally, 13 of 191 (6.8%) total patients had the presence of neuropathic pain documented in a clinic note. 3 of 191 (1.6%) patients were referred to a pain specialist for additional care, and 1 (0.52%) underwent a procedure for further workup and treatment of pain.

In this retrospective study, 9.4% of surviving burn patients developed chronic pain requiring the use of controlled substances more than 60 days following discharge. The most commonly affected anatomic regions in chronic pain patients were the bilateral lower legs. 1.6% of patients necessitated referrals to a pain specialist for their symptoms, and 0.52% underwent a procedure for additional workup and treatment. Future work will investigate patient factors associated with the development of chronic post-burn pain.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2086

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