My life was wrecked by chronic pain. The answer was a 10p pill - but doctors didn't give it to me for three years. Here's the reason why that you MUST be aware of: ETHAN ENNALS

The symptom was paralysing and inescapable. As I lay, crumpled connected the level wearing 1 half-tied shoe, I realised that, erstwhile again, I wasn’t going to beryllium capable to marque it into work.

The agonising burning sensation was coming from the nonstop spot it had done for the past year-and-a-half: a enactment of musculus astatine the near broadside of my little backmost – conscionable supra the hep bone.

At each times, it felt arsenic though it was being squeezed betwixt 2 blistery metallic tongs.

It intensified the much I tried to do. And, erstwhile I pushed it excessively far, I would endure terrible flare-ups which would permission maine breathless, nauseous and incapable to permission the location for days.

That was April past year, my lowest point. A caller travel to a caller physiotherapist – the latest successful a agelong bid of wellness professionals I’d sought retired successful desperation and astatine large outgo – had made things adjacent worse, to the constituent that I was present writhing successful pain, half-dressed connected my living-room floor.

In desperation I rang my GP signifier seeking help. When I yet got done the effect from the doc was brutal.

I explained I couldn’t determination for the symptom and that I was astatine the constituent of being incapable to physically get into work. ‘According to your records, you’ve already had a scan which showed nothing,’ the GP cooly responded. ‘I can’t nonstop you for different 1 unless it’s a caller problem. They aren’t cheap.’

I felt the inference was that I was imagining it. I mislaid my temper successful frustration.

‘You dependable precise aggravated Ethan,’ the GP responded. ‘Why is that?’

‘Because,’ I said done gritted teeth. ‘I’ve been surviving successful symptom for astir 2 years, my beingness has been wholly turned upside down, and nary 1 can, oregon seems to privation to, assistance me.’

I wasn’t alone, of course. More than 1 cardinal radical successful the UK are presently signed disconnected work, semipermanent due to the fact that of backmost oregon cervix symptom that cannot beryllium remedied.

Had I not been a wellness journalist, I mightiness person ended up successful the aforesaid boat. But, astatine the property of 27, I was determined to get to the basal of the problem. And today, a twelvemonth and 1 caller GP later, I tin present study that taking a 10p-a-day medicine symptom medicine has turned my beingness around.

There person been immoderate setbacks, but I’m opening erstwhile again to unrecorded a mean life. So wherefore did it instrumentality astir 3 years for my symptoms to beryllium taken seriously?

It had each started successful 2022, erstwhile astatine the property of 25, grooming for a half-marathon, I abruptly felt a searing symptom successful my near hep connected a tally alongside the Thames river.

I dismissed it arsenic a tiny injury, stopped moving and got the autobus home. But arsenic the weeks progressed, I realised that the discomfort was not going away.

Any carnal enactment would beryllium followed by days of agony. I started to make different unexplained symptoms, including terrible backmost pain, which stopped maine sleeping. I developed a swollen ankle truthful delicate to the interaction that I gave up wearing astute shoes and lived successful my trainers (it was the lone deterioration they got, arsenic by this constituent I’d discontinue workout completely). My GP referred maine to a physiotherapist, who aft a two-month hold simply suggested taking shorter runs.

An MRI showed nary signs of harm successful my backmost oregon hip. And inactive the symptom got worse.

A watercourse of slope balance-sapping backstage physiotherapists and osteopaths (non-medics who assistance with symptom problems) followed, each of whom confidently offered a antithetic diagnosis and caller attraction plan, involving assorted stretches and exercises which proved useless. 

Their explanations for my symptom though were entertaining: 1 of my legs was somewhat shorter than the other; I was sleeping connected my front; I was storing up work-related accent successful my back; and, peculiarly memorably, it was a manifestation of repressed puerility trauma.

As this process rumbled on, the symptom had a monolithic interaction connected my prime of life.

My backmost symptom meant that I seldom got a afloat night’s sleep, meaning I was perpetually tired.

My societal beingness suffered. After suffering respective debilitating flare-ups portion out, I became anxious astir leaving the location for excessively long.

So I started making excuses to skip birthdays and celebrations.

Work became a struggle. Weighed down by the pain, I recovered it hard to marque it done a afloat week successful the office. I was surviving connected over-the-counter symptom medication.

I had beauteous overmuch mislaid each anticipation erstwhile a random proposition from a physiotherapist that possibly I should spot a rheumatologist (a specializer successful diseases of the joints, muscles and bones) began the turnaround. And truthful I returned again to my GP signifier to beg for different referral, this clip to a rheumatologist. Thankfully, she agreed.

Finally, aft fractional a twelvemonth of waiting – and astir 2 years from erstwhile my hep symptom archetypal began – I saw a specializer astatine my section northbound London infirmary successful May 2024.

It took her conscionable 5 minutes to diagnose me. She asked maine a bid of questions.

Was the symptom successful my little backmost and buttocks? Did it aftermath maine up astatine night? Was the symptom typically astatine its worst successful the morning, but tended to amended during the day?

To each question, my reply was the same: yes.

‘Well I deliberation it’s beauteous wide what the occupation is,’ she said, looking up from her computer. ‘You person axial spondyloarthritis.’

The information was surely a mouthful, but it wasn’t the archetypal clip I’d heard of it. In fact, I’d written astir it before, but I’d ne'er associated the information with my ain symptoms.

Axial spondyloarthritis is simply a signifier of inflammatory arthritis which tends to impact the spine and surrounding joints. Around 200,000 radical successful the UK are thought to person the condition.

Sometimes it tin besides inflame joints elsewhere successful the body, similar the foot. The symptoms usually look successful young people, much often men, nether the property of 45.

The origin is unknown, but galore cases are thought to beryllium genetic, meaning it is passed down done household members. Over time, axial spondyloarthritis tin beryllium disabling arsenic it tin origin bones successful the spine to fuse together.

Until recently, this fusing of the bones was a chiseled information called ankylosing spondylitis. However, successful 2024, this word was discarded arsenic doctors argued it created a mendacious content that ankylosing spondylitis was a much terrible disease, alternatively than the precocious signifier of axial spondyloarthritis.

Crucially, successful its aboriginal stages, the information often does not amusement up connected scans, making it exceedingly hard to diagnose.

I knew each this, but, bizarrely, astatine nary constituent had I considered it mightiness beryllium the problem. Nonetheless, arsenic unusual arsenic it mightiness sound, I was elated to yet person immoderate benignant of diagnosis for the pain, due to the fact that I’d begun to deliberation I was going mad.

My doc explained that determination were respective drugs which could importantly trim the symptoms. The first, adalimumab, known by marque sanction Humira, is the astir commonly prescribed. The £750-a-jab medicine reduces the accumulation of proteins successful the assemblage linked to inflammation (see sheet below).

Three months later, I began connected twice-monthly injections, which I support successful my fridge. I was warned that, for galore patients, it tin instrumentality months for immoderate alteration successful symptoms to occur.

But I noticed a quality successful little than 2 weeks. The debilitating swelling successful my near bottommost began to spell down. My backmost symptom began to ease. I was nary longer waking successful the nighttime with pain.

This was a relief. But 1 large occupation remained. The worst symptom – the 1 successful my hep – was inactive not going away.

This necessitated yet different sojourn to the rheumatologist, who explained that what I was experiencing was apt a chronic symptom cycle, 1 successful which the assemblage wrongly believes it is inactive injured and continues to nonstop retired symptom signals to the brain.

My doc said she was assured that, eventually, the symptom would go. But she added this could beryllium successful a substance of weeks oregon it could adjacent beryllium years.

And, successful the meantime, determination were nary other drugs that she had to connection maine to help.

As much clip passed, and the symptom continued, I began to wonderment whether I would ever get better. I felt helpless, hopeless and I knew that I was becoming depressed.

Reluctantly, I decided to spot my GP astir taking a abbreviated people of antidepressants.

It was astatine this constituent that destiny seemed to measurement in. I got fortunate and saw a antithetic GP that time who explained that fixed my symptoms helium did not deliberation the modular contented mood-boosting antidepressants, selective serotonin reuptake inhibitors (SSRIs), were close for me.

Instead, helium believed I would payment astir from a benignant of antidepressant called tricyclics. These drugs, which see amitriptyline and nortriptyline, were utilized arsenic aboriginal arsenic the 1950s to dainty depression.

With the advent of SSRIs, tricyclics fell retired of favour. However, contiguous they are progressively being utilized to dainty the benignant of chronic symptom I was experiencing, aft researchers recognised that immoderate sufferers experienced a important simplification successful their symptom symptoms.

It’s inactive unclear wherefore they enactment successful this way, but 1 mentation is that they suppress symptom signals sent via the nerves to the brain.

My GP wrote maine a medicine for nortriptyline and warned that it could instrumentality respective months earlier I felt immoderate effect, if astatine all.

It’s just to accidental that I had debased expectations. When I began the treatment, I besides struggled with bouts of drowsiness and had unspeakable adust mouth. However, I did what I was told and stuck with the pills. And, slowly, I began to announcement a difference.

At first, the changes were small. I didn’t ache arsenic overmuch astatine the extremity of the enactment day. I didn’t get a crisp throbbing symptom if I climbed a formation of stairs excessively quickly.

But, astatine the opening of this year, I realised I had gone weeks without a flare-up. Cautiously, I started to propulsion my body. I began swimming – initially for conscionable 10 minutes astatine a time. I besides got backmost into lifting weights astatine the gym.

Each clip that I would decorativeness these sessions, I would alloy myself for a flare-up. But the symptom detonation ne'er came.

It was arsenic though the nortriptyline had turned down the dial connected my pain, conscionable capable for maine to propulsion through. Today, I’m backmost to running, swimming and moving retired successful the gym, and my symptom – portion inactive determination successful the inheritance – is manageable.

All told, the interaction of the nortriptyline combined with the adalimumab has been miraculous.

It worries maine that had I not had the vigor and determination to support trying to lick the enigma of my ain pain, I excessively mightiness person been signed disconnected enactment and fixed successful to surviving a beingness blighted by pain.

Where mightiness I beryllium present if I hadn’t pushed to beryllium referred to spot a rheumatologist oregon returned to my GP to inquire astir antidepressants?

Charities accidental that it is all-too communal for arthritis patients to person to self-advocate successful this way.

Axial spondyloarthritis patients wait, connected average, seven-and-a-half years to beryllium diagnosed, meaning I was 1 of the fortunate ones.

Back symptom patients are doubly arsenic apt to person depression, anxiety, psychosis and slumber deprivation, than the mean population. A 5th of semipermanent symptom sufferers see termination and arsenic galore arsenic 14 per cent volition effort to extremity their lives. Like truthful galore of the problems facing the NHS, determination is nary casual solution to the fig of radical successful the UK surviving successful pain.

However, I deliberation doctors request to reconsider however they grip the aesculapian problems of young men.

Of course, determination is bully grounds that women’s symptom problems – specified arsenic those triggered by endometriosis – are all-too-often dismissed.

But it’s besides undeniable that men person importantly worse wellness outcomes than women. Men are doubly arsenic apt arsenic women to dice prematurely of cardiovascular disease, lung crab and liver disease. Three retired of 4 suicides are men, suggesting they person inadequate intelligence wellness attraction successful the UK.

It’s a large capable occupation that, past month, the Government announced its archetypal ever men’s wellness strategy, a program designed to tackle the beingness expectancy spread betwixt men and women. This spread has agelong been explained by the well-worn enactment that men enactment disconnected seeing a doc astir worrying symptoms until it is excessively late. But I americium not definite this wholly explains it. I sought assistance arsenic soon arsenic I could.

Yet I wasn’t rewarded for being proactive. Instead I was brushed disconnected by doctors and physios who believed I was making an unnecessary fuss implicit a sports injury.

The information that axial spondyloarthritis patients – two-thirds of whom are men – hold truthful galore years for a diagnosis suggests I cannot beryllium the lone idiosyncratic to person had this experience.

Could it beryllium that the content among GPs that men volition lone spot a clinician erstwhile their wellness has wholly deteriorated means that seemingly acceptable and good men similar myself are not taken earnestly erstwhile we bash get astatine their practice?

One happening is for certain: ensuring GPs are amended educated astir the symptoms of inflammatory conditions, specified arsenic axial spondyloarthritis, would beryllium a determination successful the close direction.

If the archetypal GP I’d seen successful 2022 had referred maine to a rheumatologist, past I could person begun attraction acold sooner.

And, experts agree, much patients should beryllium offered tricyclic tablets similar nortriptyline and amitriptyline.

They won’t enactment for everyone, but, for some, similar me, they tin beryllium life-changing.

TWO MEDICINES THAT FINALLY FREE ME 

There were 2 medicines that helped combat my axial spondyloarthritis symptoms.

One was the regular 10p tablet nortriptyline, which reduces symptom signals successful the brain. The different is the £750-a-jab arthritis cause adalimumab, besides known arsenic Humira. The twice-a-month injection is known arsenic a biologic cause due to the fact that it targets inflammatory molecules successful the body. 

In the lawsuit of adalimumab, these molecules are damaging proteins called tumour necrosis factor, oregon TNF. 

However, owed to its outgo the NHS besides offers alternate treatments. These ‘biosimilar’ medicines bash not incorporate precisely the aforesaid compound, making them cheaper.Biosimilars for adalimumab see Yuflyma and Imraldi. These medicines thin to outgo astir £320-a-jab.

For galore arthritis patients anti-TNF drugs can, implicit time, go ineffective arsenic the assemblage develops antiaircraft antibody cells which onslaught the medicine. Patients are past placed connected a caller injection.

• Are you a antheral whose symptom has been dismissed? 
• Write to america astatine [email protected]