Understanding pain through a biopsychosocial framework is essential for effective, patient-centered care. Among osteopaths, misconceptions about pain mechanisms may hinder appropriate clinical reasoning, patient communication, and treatment options. This study assessed the knowledge and attitudes of osteopaths practicing in Switzerland regarding pain, and explored factors associated with contemporary pain-related beliefs. A cross-sectional online survey was distributed to practicing Swiss osteopaths. Pain knowledge and attitudes were assessed using the Knowledge and Attitudes of Pain (KNAP) questionnaire, which comprises two domains: Pain physiology and influencing factors and Treatment and management. Sociodemographic and educational variables were collected, and associations with KNAP scores were examined using bivariate and multivariable regression analyses. A total of 262 osteopaths participated. The mean total KNAP score was 109.5 ± 16.0, indicating generally good knowledge and moderately positive attitudes toward pain. Scores were highest in the Pain physiology and influencing factors domain (mean = 89.0 ± 11.3). Completion of pain-related continuing education and academic-level training were independently associated with higher knowledge and more adaptive attitudes (p < .01). Conclusions: Swiss osteopaths demonstrate a sound understanding of pain science, yet variability persists. Pain- related education appears to be the key determinant of both knowledge and attitudes, supporting the notion that cognitive understanding fosters attitudinal and behavioural change. Integrating structured, evidence-based pain education throughout osteopathic training may strengthen biopsychosocial practice and improve patient communication.
