The Back Pain That Had Me Living on Painkillers (Until an Online GP Diagnosed What Three Physiotherapists Missed)

I'd been sleeping on the floor for two months. The bed was agony, the sofa worse. I'd restructured my entire life around back pain: standing desk, cushion fortress in the car, strategically placed heat pads in every room. I was 35 and moved like I was 85.

The NHS physiotherapist gave me a photocopied exercise sheet. The private physio (£80 per session) provided deep tissue massage that helped for exactly 24 hours. The chiropractor claimed I needed 20 sessions at £60 each. Meanwhile, I was taking ibuprofen and paracetamol cocktails every four hours just to function, my stomach burning from the constant NSAIDs.

The Back Pain Epidemic Nobody's Treating Properly

80% of UK adults experience back pain, yet treatment remains medieval: rest, painkillers, wait for it to improve. When it doesn't, you join a four-month physiotherapy waiting list for six sessions of generic exercises that assume all back pain is identical. The system treats symptoms, not causes, creating chronic pain patients dependent on increasingly strong medications.

The economic impact is staggering. Back pain is the leading cause of disability globally, costing the UK £12 billion annually in lost productivity. Yet accessing proper diagnosis requires private MRI scans (£500+), private consultants (£250+), and endless appointments that might eventually identify the actual problem. Most people give up, accepting chronic pain as inevitable.

The 30-Minute Consultation That Found the Real Problem

The Online GP took a different approach. Instead of assuming muscular strain, she conducted a systematic assessment via video. "Show me exactly where it hurts. Demonstrate what movements trigger it. When is it worst?" She asked about bowel habits, leg numbness, night pain – red flags others had ignored.

Her diagnosis shocked me: suspected sacroiliac joint dysfunction, possibly linked to inflammatory arthritis. My "back pain" wasn't actually back pain – it was SI joint inflammation mimicking lumbar problems. This explained why traditional physio failed, why NSAIDs barely touched it, why certain positions provided relief whilst others caused agony.

Treatment That Actually Targeted the Problem

She prescribed a completely different approach: naproxen (a longer-acting anti-inflammatory), amitriptyline 10mg at night (for neuropathic pain), and a muscle relaxant for acute spasms. She arranged a private MRI through their partner network (£199 vs £500+ elsewhere) and blood tests for inflammatory markers. Most importantly, she referred me to a rheumatologist, not another physiotherapist.

The medication combination was revolutionary. Within a week, I slept in bed for the first night in months. The amitriptyline stopped the nerve pain that had been misdiagnosed as muscle strain. The naproxen actually reduced inflammation rather than just masking pain. The muscle relaxants ended the spasm cycles that locked me rigid.

The Diagnosis That Changed Everything

The MRI confirmed SI joint inflammation and early signs of ankylosing spondylitis – an autoimmune condition causing spine fusion if untreated. Three physiotherapists had missed it because they'd assumed mechanical back pain. The online GP had suspected it within 30 minutes because she'd actually listened to the symptom pattern.

The rheumatologist started biological therapy, but the online GP continued managing day-to-day symptoms. She prescribed sulfasalazine when biologics weren't enough, adjusted pain medications based on inflammation markers, and provided rescue prescriptions for flares. This coordinated care transformed me from disabled to functional within three months.

Why Online GPs Excel at Chronic Pain Management

Chronic pain requires detective work, not assumption. Online GPs have time to investigate properly. They can prescribe the full range of medications immediately: strong anti-inflammatories, neuropathic medications, muscle relaxants, even controlled drugs when justified. They coordinate investigations and specialist referrals whilst managing symptoms.

The continuity matters enormously. The same doctor tracks your progress, adjusts medications, identifies patterns. When I developed NSAID-induced gastritis, she immediately switched to COX-2 inhibitors and added stomach protection. When amitriptyline caused drowsiness, we adjusted timing and dosing. This responsive care is impossible through fragmented NHS services.

Frequently Asked Questions

Can online GPs prescribe strong painkillers for back pain? Online GPs can prescribe all non-controlled analgesics including NSAIDs, neuropathic medications (gabapentin, pregabalin), muscle relaxants, and compound preparations. They can also prescribe some controlled drugs with appropriate assessment and monitoring.

How can online doctors assess back pain without physical examination? Many back pain diagnoses rely on history and movement observation, both possible via video. Online GPs identify red flags requiring physical examination whilst treating the 95% of cases that don't. They can arrange investigations and refer for examination when needed.

What if I need an MRI or X-ray? Online GPs arrange imaging through partner networks, often faster and cheaper than NHS or standard private routes. They provide referral letters for NHS imaging where appropriate and interpret results promptly, adjusting treatment based on findings.

Can online GPs help with chronic pain management? Absolutely. They excel at chronic pain, prescribing combination therapies, adjusting medications based on response, and providing consistent care. They can refer to pain clinics, coordinate with specialists, and manage the medications most GPs won't prescribe.

I recently ran a 10k. Six months ago, I couldn't walk to the corner shop. The difference wasn't more physiotherapy or stronger painkillers – it was correct diagnosis and targeted treatment from a doctor who had time to actually investigate my pain.

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