More than 20,000 acute hospital admissions are seen annually due to burn injuries. Burns present with various challenges (wound management, infections and rehabilitation). Pain is also an important aspect as it is seen with burns and its management (debridement, physiotherapy).

The pain is seen due to the damage to sensory organs in the skin and tissues underneath. The inflammatory response adds to the pain. Burn size is measured as the total area involved of the skin. Various charts can be used to estimate burn size (rule of nines, Lund-Browder chart). Burns are classified according to the depth of injury involved:

Inflammation and tissue destruction leads to increase of inflammatory markers that irritate the nerve endings leading to pain. There is sympathetic discharge leading to almost 100 % increase in resting metabolic rate. The pain may be in the background and continuous or procedure related (dressing change, debridement, skin grafting). It may present as a breakthrough pain. Pain becomes chronic after 6 months and is associated with burns of large size or may be due to entrapment of nerve in the scar. Anxiety and depression are associated with burns and may alter pain perception.