Beliefs, attitudes, knowledge, and behaviours of physical therapists towards pediatric complex regional pain syndrome.

Abstract

Background: Pediatric complex regional pain syndrome (CRPS) is a debilitating chronic condition that affects the quality of life and psychosocial development of children and adolescents. Despite increasing recognition, significant diagnostic and therapeutic challenges persist, partly due to the lack of clinical criteria tailored to the pediatric population.

Aim: To evaluate current diagnostic and therapeutic practices in pediatric CRPS, identifying barriers to timely intervention and gaps in provider knowledge.

Methods: Physiotherapists who had treated at least one pediatric CRPS case in the past two years were surveyed. The online questionnaire included 40 questions divided into three sections: Professional knowledge, therapeutic approaches, and personal perceptions. Data were analyzed using descriptive statistics and χ ² tests.

Results: Most participants worked in private clinics (71%) and collaborated with other healthcare professionals. About 53% had specific training in pediatric pain, while 40% had training in CRPS. Only 13% had received training in cognitive-behavioral therapy (CBT). The use of the Budapest criteria was limited, primarily applied during the diagnostic suspicion phase. The most common therapeutic strategies included mirror therapy (40%) and relaxation techniques (80%). The main reported challenges were the lack of specific clinical guidelines (60%) and insufficient professional training (47%).

Conclusion: Physical therapists are key contributors to multidisciplinary diagnosis and play a central role in managing pediatric CRPS in most cases, adopting a collaborative and largely non-pharmacological approach. However, the absence of standardized clinical guidelines limits treatment consistency. The development of pediatric-specific protocols and enhanced training in psychological therapies such as CBT is recommended.