Overview of pain associated with major burns

Major burns are usually associated with mixed nociceptive and neuropathic pain. Pain is often continuous, with intermittent exacerbations (including pain associated with procedures).

A burn is considered major if it meets any of the criteria for referral of a burn to a specialist centre (see Criteria for referral of a burn to a specialist centre). When assessing the burn, always consider whether it was a nonaccidental injury and ensure management plans address the psychosocial impact of major burns.

Pain associated with major burns is commonly undertreated. Adequate pain management facilitates procedures and rehabilitation, and reduces the risk of transitioning from acute to chronic pain, or the patient developing posttraumatic stress disorder. Using a pain management protocol can improve the patient’s pain experience and results in more timely referrals to specialist pain medicine physicians.

For advice on managing minor burns, including pain associated with them, see Minor burns.