An alternative to Ergon Grips that works for me is the ESI grips made from reasonably resistant foam. I use the thickest versions.

As they are the same thickness all round, they are easier to set up than Ergon grips.

Thank you both, and particularly Andre for the detailed reply, lots of really helpful stuff to consider. I'll think on it a bit more and try taking photos of me on the bike to get a better idea.
Thanks again

First of all, Adrian, you have to face it: there's nothing ergonomic about the bars in your photograph. The only good thing about them is that they allow you to change your handhold and get temporary relief before the pain starts again. None of the multiple possible handholds are much chop either to your hands or your wrists, which in any discussion must be viewed as a combination.

North Road bars have only one grip, but it is immensely tailorable to get exactly the right ergonomic grip, with your hands in a natural position and your wrists in line with your hands. (Theoretically you can ride with your hands on the "bulge" inboard of the grips, but on my bikes there are bells, computers, switches, warning lamps, phone and other nav mountings, and brake lever fittings inboard of the grips because I insist on reaching all controls without taking a hand off the grip, so no space to put your hands. See above about the multiple handholds on your current bars.)

I've found the Uno-Kalloy North Road bars to be the easiest to set up, with long straight grip sections. You can get them in steel or alloy and in several widths; I like the 620mm width so that no part of my arms need to bend inwards and my forearms are parallel with the hands on the grips and the wrists straight in line with the hands. The steel Una-Kalloy bars you can often get free at many bicycle dealers because they throw off so many in order to sell ignorant new cyclists guaranteed pain generators that "look sporty" on their new bikes. The Uno-Kalloys also have a brilliantly ergonomic outward angle (viewed from directly above) on the handlebar grips, so that your hands fall naturally on them.

Any North Road bars properly set up will make your bike look a little odd, because the best ergonomic setup requires a downward angle (somewhere between 20 and 45 degrees below the horizontal) of the handlebar grips, which in turn means you have to raise the point where the stem meets the handlebars to maintain your preferred back angle on the bike; this you can do either by adapter to lengthen the steering tube or angling a long adjustable stem upwards, or both. I keep an adjustable stem on most of my bikes permanently, though it is probably a dozen years since I last made a tiny, tiny change when I lowered the saddle a smidgin because old cyclists shrink a bit, and consequently had to change the position of the grip to maintain the preferred relationship of my body and hands to the grip to within less than a millimeter in all directions.

It helps to draw out a side view of the handlebars and you on the bike and measure with a protractor, especially if you don't want to spend a good bit of money on stems you won't use. Also alternative positions with a straighter back, and a more sporting back. I use both an adjustable steering tube and an adjustable stem where I can*, but if you manipulate your drawing a bit, and spend some time with the catalogues of stem suppliers, you'll probably find an adjustable stem long enough give you all the height you want. The reach actually adjusts automatically, another good reason to have a sketch to convince you of how simple bike geometry can be. If you want a more sporty back, you also need to move the handlebars forward as you lower them, and an angled adjustable stem will do this. Conversely, if you want a comfortable seat on a commuter bike, and bring the bars back and up by turning the stem upwards on its swivel to accommodate a straighter back, you'll find it happens automatically without any further expense. For this reason a toollessly adjustable stem, with a flip lever to lock it, would be most desirable but I regret to say I don't know of one that's long enough to do any good. The most common, popular toollessly adjustable stem, also made by Uno-Kalloy, is too short to give a big range of adjustment; your bike must already be pretty near the desired proportions before it can get to work.

For grips I love the Brooks saddle leather rings held together by tiny bicycle spokes. They're hard but I don't notice even though I cycle in unlined dress leather gloves, zero gel. They keep any vibrations from the road that wriggle their way past the 60mm Big Apples from my hands, and the correct position of my hands on the handlebars keeps me happy. The Ergons, mentioned by In4 above, are also highly reputed but don't last as long as the Brooks grips.

Don't saw the ends off the Uno-Kalloy handlebar ends until you've fitted everything that goes on your bars and test-fitted your grips.

I don't know of any desirable handlebars with a built-in stem. In fact, the only handlebars with a built-in stem I know of consist of just a piece of pipe welded onto the bars, which forces the rider to use perfectly horizontal grips. Difficult to think of a more hostile ergonomic setup. They're found only on cheap bike-shaped objects in supermarket chains.

Finding the correct position on the bike can be a revelation for those in pain. I know, I bought my physio a new big BMW every second year until I decided to take the ergonomic details into my own hands, no pun intended.

Good luck.

*On my favorite bike I could only get a fixed version of my favorite stem, the n'lock, at the time I was in the market. Fortunately it came with a sufficiently long steering tube extender so that it didn't matter to the outcome.

Another beginner question from me.

I'm experiencing pain in the base of my thumb and wrists, which has been diagnosed as arthritis, I'm trying a splint to alleviate the pain.  I wondered whether changing to something like North Road type bars would help when cycling as thumbs and wrists at a more natural  angle? This is despite multiple options with the hybrid bars fitted.

I've read some of the previous posts on changing handlebars and can see there sense in trying an adjustable stem before settling on the right combination of stem height and reach.  Are there north road type bars with built in added reach?

Surely grounds for excommunication and being black-balled from The Lodge!? 

Check out a movie called The Sin Eater, also known as The Order, with Heath Ledger. Don't pay any attention to the critics; those semi-literates missed all the cultural references.

I think even F-1 fans often fail to realize the high fitness levels drivers possess and the work required to get and stay there in between stints behind the wheel.

Remember David Coulthard's neck? Built like a tree trunk -- a redwoood, at that. It didn't happen on its own.

Nico Rosberg, who was Lewis Hamilton's teammate, and whose own World Drivers' Championship interrupted Hamilton's run of championships for Mercedes, immediately afterwards retired to spend more time with his family. He gave a fascinating description of how he hardly saw his family in the previous year as he worked with his trainer to prepare him to beat Lewis Hamilton, one muscle at a time. I imagine a bicycle racer who wants to win also trains muscle by muscle.

It's not surprising that track racers develop necks bigger than their thighs. The g-forces on a car racer are greater than on a fighter jet pilot, and happens multiple times over a race weekend, whereas the fighter pilot suffers his top g-forces perhaps a handful of times in an entire career, or never if there are no wars during his career.

I would think that he will be contracted to drive so has no option?

All drivers' contracts forbid bicycling or motorbiking on the public roads, permitting cycling only under the supervision of the driver's trainer because cycling is too valuable a training method to forbid. But Cadillac is a new team and Valtteri Bottas is one of the few available top drivers (ten victories, years at Mercedes, twice runner-up in the World Drivers' Championship) whose experience they need to develop their car. So, while it is unthinkable that even a new team would have overlooked such a standard clause in the contract, Bottas would have had some negotiating clout about a mainly off-road second sport.

Related information from my protege Dakota Franklin, author of the Ruthless to Win set of books: Fernando Alonso, twice world champion, thirty-something victories, universally considered one of the greats, has a clause in his contract with Aston Martin that he won't enter a race where he has unfinished business, the Indy 500, while he drives for them. It seems clout goes only so far.