Burn injuries are the most painful and debilitating conditions, but there is limited evidence supporting this statement. There is a lack of understanding of the concept whether pain management in burn patients is different from patients with pain from other ailments causing pain.

The present study by Prasad A et al compared the data on pain severity among patients presented to emergency departments (EDs) across the United States among burn and nonburn injuries. This data was collected from the National Hospital Ambulatory Care Survey. The survey results showed an association between predictor variables and pain severity as well as pain management in the ED using multivariate analyses. It was found that out of the estimated 527 million ED visits between 2010 and 2013, about 2.1 million visits were due to burns and 128 million visits were due to nonburn trauma.

Mean (SE) initial pain scores determined by patient group were burns 6.3 (0.27), nonburn trauma 5.4 (0.04), and nontrauma 4.8 (0.04), p<0.001. Mean (95% confidence period) pain records by special type of trauma were burns 6.4 (5.9-6.9), fractures 6.7 (6.6-6.9), dislocations 6.7(6.3-7.1), and sprains/strains 6.8 (6.7-6.9), p<0.001. It was determined that pain scores were higher for males that keep on increasing with age. Adjusted for age and gender, burns have a minimum effect on all types of injuries on pain score except for open wounds, contusions, and crush injuries. An opioid therapy was more likely to be effective for patients with fractures and dislocations than burn patients after adjusting for pain severity.

It was concluded that pain severity due to burns is not higher than due to dislocations, fractures, and sprains/strains and burn patients are less likely to receive opioid and nonopioid analgesics than fractures and dislocations.