Current methods of pain management in burns: behavioral and physical approaches
A burn injury is not only physical damage to tissues, but also a test of the strength of the entire human nervous system. The pain that occurs after a burn can persist for weeks and even months. At the same time, it is often not enough to cope with pain with medication alone. Modern medicine offers a combined approach, in which more and more attention is paid to non-medicinal — behavioral and physical — methods.
Why is the pain from burns special?
Burn pain is complex:
- Acute pain occurs due to damage to the skin and underlying tissues.
- Procedural pain accompanies dressings and other manipulations.
- Chronic pain can persist after wounds have healed, especially with deep burns and transplants.
The brain begins to “learn pain,” and this needs to be addressed not only pharmacologically, but also behaviorally.
Behavioral methods
Allows you to rethink your perception of pain. Patients learn to:
- Identify negative thoughts («this pain will never end»),
- Replace them with realistic ones («this is temporary, I know what helps»),
- Control behavior associated with pain (e.g., avoiding movement).
Effect: reduced anxiety, increased pain control, improved sleep.
- Training in self-regulation methods
These include:
- Breathing practices (deep diaphragmatic breathing),
- Muscle relaxation (according to Jacobson),
- Visualization (imagining coolness, healing light, etc.),
- Mindfulness meditation.
Patients who master these methods report less pain and anxiety during dressing changes.
Physical methods
- Physical therapy and early mobilization
Controlled movements improve blood flow, reduce spasms and help the brain «rewire» pain signals.
What is used:
- Stretching and strengthening exercises,
- Moderate aerobic exercise,
- Hydrotherapy (exercises in warm water).
Important: start gradually and under the supervision of a specialist.
- Tactile desensitization
Nerve endings in the burn area can become hypersensitive. The technique includes:
- Stroking with various textures (wool, cotton, fur),
- Light tapping,
- Using vibrostimulators.
The goal is to reduce skin sensitivity and reduce discomfort when touched.
- Heat and cold therapy
Some patients benefit from applying cool (not cold!) compresses. But it is important:
❗Do not use ice directly,
❗Avoid overheating and hypothermia of tissues.
Such methods should be used with caution and only on completely healed areas.
What does the research say?
Numerous reviews show that the combined use of behavioral and physical methods:
- Reduces the need for opioids,
- Improves the tolerability of procedures,
- Improves the overall quality of life of patients after burns.
For example, the Burn Model System study (USA) showed that patients trained in relaxation techniques were less likely to need sedatives during dressing changes.