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In his second article on diagnosing CRPS, specialist solicitor Visit our main CRPS Compensation page.
Types of CRPS
As if the diagnostic criteria outlined in Part 1 of this article were not confusing enough, the signs and symptoms of CRPS can develop with or without an identifiable nerve injury. So, people satisfying the Budapest Criteria were originally classified with one of two types of CRPS:
- CRPS Type 1 – without identifiable nerve damage; or
- CRPS Type 2 – resulting from specific nerve damage.
However, the problem with requiring the presence of multiple signs and symptoms to diagnose any condition is that they are rarely static. Some become worse, improve, or resolve, or new ones appear. If one of the signs or symptoms initially relied upon for a diagnosis of CRPS is no longer present, yet all others remain, does that person still have CRPS?
What also became apparent to the IASP panel was that around 15% of those diagnosed with CRPS under IASP’s pre-Budapest criteria would no longer fully meet the new diagnostic criteria.
CRPS-NOS
The panel created a third classification called CRPS-not otherwise specified (CRPS-NOS) to address these issues. CRPS-NOS captures those patients:
- not meeting – or no longer meeting – the new criteria,
- BUT whose signs and symptoms are not better explained by another diagnosis.
New CRPS types
However, time moves on, and following the 2019 Valencia consensus, four types of CRPS are now recognised. Or, more accurately, one type and three sub-types.
Main type of CRPS
- CRPS Type 1 (or chronic primary pain) – no identifiable nerve injury.
CRPS Subtypes
- CRPS Type 2 – identifiable nerve injury.
- CRPS-NOS – IASP say this term should now only apply to “patients who have never been documented to fulfil the new IASP CRPS criteria” rather than to patients who no longer meet the CRPS criteria.
- CRPS with Remission of Some Features is a new sub-type of CRPS overlapping Type 1 and Type 2. It’s aimed at patients previously documented as having fully met the CRPS diagnostic criteria but currently displaying CRPS features that are insufficient to meet them fully.