Based on the assumption regarding various risk factors causing the development of chronic neuropathic pain (CNP) and refractory responses to treatment; this study of 914 patients for the first time revealed tobacco use and substance to be risk factors for developing CNP following hand/upper extremity burns. Ascorbic acid and gabapentin or pregabalin were effective for CNP symptoms.

This study aimed to characterize the patients with CNP following hand/upper extremity burns to identify patients at high risk and the associated treatment approaches.

Patients aged >15 years admitted after hand/upper extremity burn injuries were considered. The self-described pain for more than 6 months following burn injury was regarded as CNP. It did not include pain due to prior ailment or medicines.

Risk factors for developing CNP among these burn patients, and for refractory pain (i.e., non-responsive to treatment) amongst burn patients and CNP were determined.

Fifty-five (6%) out of a total of 914 developed CNP after hand/upper extremity burns. Of these 55 patients, 29 had refractory CNP. History of substance abuse and tobacco use were noteworthy risk factors for developing CNP after burns.

Symptoms of burning sensations in patients with CNP were significant risk factors for refractory pain. On follow-up, gabapentin and ascorbic acid were linked with significant pain scores reductions in every CNP patients.

Use of tobacco and substance abuse and were the leading contributors to the occurrence of CNP after hand/upper extremity burns. Pharmacological pain treatment may help to alleviate CNP symptoms.