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Outpatient Pain Management After Burn Injury

Pain doesn’t stop at hospital discharge. Burn survivors often need continued support to manage pain safely and effectively.

From short-term opioid use to non-drug options like massage or mindfulness, there are many ways to help manage discomfort, promote healing, and reduce risk during recovery. 


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Pain After Burn Injury

Burn injuries are often described as one of the most painful types of trauma. While opioid medications are commonly used during hospitalization to manage pain, there is growing awareness of the risks tied to overprescribing and long-term use. The goal after discharge is to manage pain in ways that support healing, function, and quality of life, while minimizing risk. 

Opioid Use After Discharge

Most burn patients receive an opioid prescription when leaving the hospital. However, many stop using opioids within a few weeks. For those who do receive prescriptions, providers can support safer use through: 

Prescribing the lowest effective daily dose

Choosing short-acting opioids only

Educating patients on risks and safe use

Using screening tools to identify those at higher risk

Checking local Prescription Monitoring Programs

Non-Opioid Medications

To reduce reliance on opioids, consider:

NSAIDs and Acetaminophen

These can be scheduled together to help manage pain and may reduce the need for opioids.

Gabapentin

Often used to treat nerve-related pain and itching but should be prescribed with caution. It may not reduce the need for opioids, and withdrawal symptoms can occur if stopped suddenly.

Non-Medication Approaches

Complementary techniques and therapies may also support recovery: 

Scar massage

Can reduce pain and itching for raised or thickened scars

Cognitive strategies

Mindfulness, guided relaxation, and other behavioral techniques may help manage pain and improve coping

Moisturizers

Keeping healed skin hydrated reduces itch and discomfort

Interactive gaming

May help distract from pain during rehab sessions

Other options

Acupuncture, laser therapy, and other complementary treatments may be worth exploring

Treating the Whole Patient

Pain rarely exists on its own. Ongoing symptoms like itching, sleep disruption, anxiety, or post-traumatic stress can make recovery harder.

A supportive care plan includes:

  • Identifying and treating coexisting challenges 

  • Connecting patients with mental health or pain management services 

  • Involving family or caregivers when possible 

Opioid Use and Risk of Addiction

Most people use opioids as directed and taper off over time. However, some may develop dependence or find it difficult to stop. Factors that can influence risk include: 

  • Family or personal history of substance use 

  • Existing mental health conditions 

  • Lack of social support 

Providers can use brief screening tools to assess risk or identify signs of misuse. If needed, connect patients with addiction specialists or interdisciplinary care teams. 

Supporting Tapering and Discontinuation

Tapering off opioids should be tailored to the patient. Considerations include: 

  • Duration and dose of opioid use 

  • Whether the patient shows signs of addiction or dependence 

  • Other medical, mental health, or substance use concerns 

  • Patient’s social support and coping abilities 

Patients who struggle to discontinue opioids may benefit from referrals to addiction treatment, behavioral therapy, or specialized pain services. 

Related Resources

Managing Pain After Burn Injury
PTSD After Burn Injury
Understanding Burn Injury

Disclaimer 

This information is not a substitute for professional medical advice. Talk to your health care provider about concerns related to pain management after a burn injury. 

Attribution 

Adapted from content developed in collaboration with experts from the Burn Model Systems. Reviewed by clinicians and specialists in burn rehabilitation and outpatient pain care.