Longitudinal Trajectories and Risk Factors for Post-traumatic Chronic Pain and Pruritus Following Burn Injuries: a Prospective Multicenter Cohort Study
In brief
Half of burn survivors still report itching one year after rehabilitation
In a prospective study of 103 adults, 51% still had itching and 30% had clinically significant pain with exertion 12 months after burn rehabilitation. PTSD symptoms at admission were strongly associated with greater pain and itching, but the observational findings cannot show that PTSD causes these symptoms; whether integrated psychological care reduces the lasting burden remains unknown.
- Journal
- Archives of physical medicine and rehabilitation (Q1)
- Published
- 31 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Felix J Klimitz, Hubert Neubauer, Annette Stolle, Stav Brown, Hans Ziegenthaler, Adriana C Panayi, et al.
- PMID
- 42966589
- DOI
- 10.1016/j.apmr.2026.10.010
Why clinicians should know about it
- Picked for Plastic and Reconstructive Surgery (top studies of the week, 1 November 2026): Prospective burn-survivor cohort tracks chronic pain and pruritus
Abstract
OBJECTIVE: To characterize the longitudinal course and identify predictors of chronic pain and pruritus following burn injury. DESIGN: Prospective multicenter cohort study. SETTING: Specialized inpatient burn rehabilitation centers. PARTICIPANTS: A total of 103 adult burn survivors undergoing burn-specific inpatient rehabilitation. INTERVENTIONS: burn-specific inpatient rehabilitation. MAIN OUTCOME MEASURES: Pain at rest and pain on exertion were assessed using Numeric Rating Scales (NRS), whereas joint pain and pruritus were recorded as present or absent, at admission, discharge, and 3- and 12-month follow-up. Clinically significant pain was defined as NRS ≥4. RESULTS: At admission, 17.5% of patients reported clinically significant pain at rest, 49.5% pain on exertion, 40.0% joint pain, and 68.0% pruritus. At 12 months, prevalence decreased to 14.1%, 30.4%, 34.8%, and 51.1%, respectively. Baseline post-traumatic stress disorder (PTSD) symptoms were independently associated with higher odds of pain at rest (OR 23.8, 95% CI 3.58-347.0), pain on exertion (OR 10.5, 95% CI 3.56-36.7), joint pain (OR 12.9, 95% CI 4.24-47.3), and pruritus (OR 4.36, 95% CI 1.67-12.2). All associations remained significant after correction for multiple testing. Across time points, PTSD was associated with increased joint pain (risk difference +28.96%, 95% CI 19.64%-38.29%) and pruritus (+9.7%, 95% CI 0.4%-19.1%). CONCLUSIONS: Chronic pain and pruritus remain common one year after burn injury despite structured rehabilitation. PTSD was consistently associated with greater symptom burden, supporting the need for integrated psychological and somatic rehabilitation strategies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.