EFFICACY OF PHYSICAL THERAPY IN MANAGING POST-BURN NEUROPATHIC PAIN: A RANDOMIZED CONTROLLED TRIAL IN PAKISTAN

Abstract

Background: Post-burn neuropathic pain (NP) is a common complication that hinders rehabilitation and quality of life. While pharmacologic management is prevalent, physical therapy (PT) offers a non-invasive, cost-effective alternative, especially in low-resource settings. Objective: To evaluate the efficacy of a structured PT program in reducing NP and improving functional outcomes among Pakistani burn patients.  Methods: A randomized controlled trial was conducted on 30 adult patients (13 females, 17 males; aged 20–50 years) at Civil Hospital Karachi. Patients with second- or third-degree burns and persistent NP were randomly allocated to PT (n=15) or control (n=15) groups. The PT group received a 4-week protocol of TENS, desensitization, ROM exercises, and functional training. Outcomes assessed were pain (VAS), joint range of motion (ROM), and functional independence (Modified Barthel Index).  Results: The PT group showed a significantly greater reduction in VAS pain scores (mean change −3.5 ± 1.0) compared to the control group (−1.2 ± 0.8; p < 0.001). ROM improved by 30° ± 8° and Barthel Index by 22.5 ± 5.2 points in the PT group (both p < 0.001).  Conclusion: Physical therapy significantly reduces NP and improves mobility and function. PT should be integrated into standard post-burn rehabilitation protocols in Pakistan.