I have an upcoming 15 hour flight next year with British Airways (not yet booked, so still flexible on the exact flight and date), however I have a chronic spinal condition that becomes very painful when sitting/standing for prolonged periods - and could cause lasting nerve damage if the pain is suppressed with medication. I need to be able to lay down to every few hours to fully relieve the pressure, and I really don't want to have to lay down in the middle of an aisle for obvious reasons.

I recently took an 8 hour flight and while Air Canada were gracious enough to provide a free upgrade to bulkhead seating, even with the extra leg room the 8 hours was reaching my limits and I had to spend the entire first day of my holiday in bed to recover from the flight. So I'm sure you can understand why I'm concerned about a 15 hour flight.

I have contacted BA and they have offered me the same free upgrade to bulkhead seating, but they were not willing to provide any form of class upgrade - even when provided with a doctor's note explaining the need for laying horizontal.

I found another post on this forum about the same subject, which also came to the same conclusion that they don't offer this sort of medical assistance, but that post and the majority of the replies are over 12 years old and I would like to know if anything has changed since then?

Has anyone had any success in getting a class upgrade for medical reasons since then?
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And as a follow-up to the above questions; (assuming nothing has changed and a class upgrade for medical reasons is still not possible), are there any alternatives I could be requesting? E.g. discounted rates rather than complimentary upgrades to at least help cover the cost of paying for business class, or booking 3 seats to allow for laying in economy.