Burn Scar Contracture & Hypertrophic Burn Scars

Common Symptoms

• Thickened, raised, or tight scar tissue at the site of a healed burn
• Reduced range of motion at a nearby joint if the scar crosses it
• Pain, itching, or tightness at the scar site
• Difficulty with fine motor tasks if the scar affects the hand

Why It Happens

During burn wound healing, the body can lay down excess collagen in a disorganized way, producing a thickened, less flexible scar; when that scar crosses a joint, the reduced flexibility can physically limit how far the joint can move.

Why It Can Become Persistent

Once a hypertrophic scar has matured, it doesn't remodel back to normal, flexible skin on its own — the disorganized collagen structure is a lasting tissue change, which is why burn scars and any resulting contracture typically need active, ongoing management.

Who Commonly Gets It

This affects people who have had significant burns, particularly deeper burns that took longer to heal or required grafting, and is more likely to develop into a problematic contracture when the scar crosses a joint.

How It Is Usually Diagnosed

Diagnosis is clinical, based on the appearance of the scar and a functional assessment of range of motion at any nearby joints.

Traditional Treatment Options

• Scar massage and silicone sheeting: Standard early interventions to help soften and flatten a healing scar.
• Splinting and stretching: To help maintain or regain joint range of motion.
• Corticosteroid injections: Can help soften and flatten thickened scar tissue.
• Surgical scar release: Considered for significant contractures limiting function.

Why Someone Might Start Looking for Another Option

People managing hypertrophic burn scars, particularly those affecting hand function, often look for additional non-surgical options to add to standard scar management.

Where Shockwave Therapy May Fit

A double-blind, randomized, sham-controlled trial of 48 patients with hand burn scars found shockwave therapy significantly improved pain, reduced scar thickness, and improved blood flow to the scar, along with improvement on two specific hand-function tasks (card-turning and picking up small objects). It did not, however, produce a significant improvement in grip strength, scar pigmentation, or scar flexibility specifically — a mixed but genuinely positive result on several real measures, and we think it's important to name the outcomes that didn't improve, not just the ones that did.

How Shockwave Treatment Works for This Area

Shockwave therapy would be considered alongside standard scar management — massage, silicone sheeting, splinting, and stretching — as part of a coordinated plan, particularly when hand function is affected.

What the Treatment Feels Like

Patients typically describe a tapping or pressure sensation over the scar; your provider will discuss what to expect based on your evaluation.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Recently healed or still-healing burn wounds — this evidence applies to established, mature scars
• Significant contractures where surgical release may be more appropriate, per specialist evaluation
• Active infection or open areas within the scar
• Certain circulatory, neurological, or bleeding-related conditions, per your provider's screening

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.