Persistent pain & symptoms in Utrecht | Premium Osteopathy IMC

Thomas M Pfaff

4 October 2026

Enlace Academy

You booked an appointment because your back hurts, your neck feels stiff or everyday movements have become uncomfortable. Your first question is practical: what might help?

Many patients come to IMC with persistent symptoms, including back or neck pain, headaches, digestive complaints or difficulties following an injury or surgery. Assessment helps determine whether osteopathic treatment is appropriate or further medical evaluation is needed.

Mostly a focused intake and a short course of treatment are appropriate. In other situations, symptoms persist, previous treatments have provided limited benefit, or additional difficulties—such as poor sleep and fatigue—need attention.

For international residents in Utrecht, there may be another challenge: understanding an unfamiliar healthcare system while some of your medical history remains abroad.

At IMC Utrecht, we start by assessing your situation. Together, we consider whether osteopathic treatment is appropriate, whether further medical assessment is needed and whether broader support could be useful.

Start with an assessment, rather than a predetermined treatment

Your first appointment includes a discussion of your symptoms, medical history, previous treatment and daily activities, alongside an appropriate physical examination.

We want to understand:

When your symptoms started and how they have changed.
What has already been investigated.
Which treatments helped, and which did not.
How symptoms affect your work, sleep and everyday life.
What you hope to achieve.

If you have received care outside the Netherlands, bring relevant reports and an up-to-date medication list. Ask in advance whether a summary or translation would be helpful.

The intake is also an opportunity to discuss the possibilities, limitations and risks of treatment. Where your symptoms require assessment by a GP or specialist, we discuss that with you.

When is osteopathic treatment appropriate?

Osteopathy involves hands-on assessment and treatment. Depending on your situation, it may be considered as part of an approach to musculoskeletal symptoms, alongside advice about movement and daily activities.

At IMC, suitability is assessed individually. Treatment is not automatically the right choice for every symptom, and a particular response cannot be guaranteed.

If we agree on a short treatment programme, we set practical goals. These might include moving more comfortably, managing a working day or returning to a valued activity.

We also agree when to review progress. If improvement is insufficient, we reconsider the plan rather than simply continuing the same treatment.

When is a broader assessment useful?

Persistent symptoms do not automatically mean that something is wrong throughout your body. Several symptoms occurring together do not prove that they share one cause.

They can, however, raise questions worth exploring.

A broader review may be useful when:

Symptoms continue despite previous treatment.
Pain, sleep difficulties or fatigue affect several parts of daily life.
Different healthcare professionals are involved and the next steps are unclear.
Advice is difficult to reconcile with your circumstances.
Relevant medical information is spread across different providers or countries.

We review what is already known, what remains uncertain and which questions need further assessment.

Where does the kPNI perspective fit?

At IMC, a clinical psychoneuroimmunology—or kPNI—perspective may help structure questions about the interaction between physical symptoms, psychological processes and everyday circumstances.

Depending on your needs, we may discuss sleep, physical demands, movement, nutrition, stress and recovery.

This perspective does not establish a diagnosis by itself. Normal test results do not prove that stress is causing your symptoms, and a connection in time does not establish a cause.

We distinguish between documented medical findings, your experience and possible explanations that require further evaluation.

Not everyone needs an extensive kPNI assessment. We explore these topics when they are relevant to your question and with your agreement.

Finding your way through healthcare in Utrecht

Receiving care in a new country can involve unfamiliar referral routes and different expectations about consultations.

If a recommendation is unclear, ask your healthcare professional to explain the reasoning and the follow-up plan. Useful questions include:

What have the investigations shown?
What remains uncertain?
Why is this the recommended next step?
When should we review progress?
Who should I contact if things change?

If language makes the discussion difficult, ask what support is available. For complex explanations or important decisions, professional language assistance may be appropriate.

Preparing a brief summary of your symptoms and questions can help you make the most of an appointment.

When is medical care coordination needed?

Sometimes the main difficulty extends beyond an individual treatment. You may have several healthcare professionals involved, outstanding results or uncertainty about who is following up.

In that situation, we can discuss whether broader, independent medical care coordination through Enlace Care may be appropriate.

This support may include organising information, preparing consultations, clarifying responsibilities and following up agreed next steps.

Care coordination and a broader kPNI assessment are separate choices. You may need help organising your care without needing an extensive exploration of lifestyle or personal history.

Your GP and specialists remain responsible for their own medical assessment and treatment.

How does this work in practice?

The route depends on your situation:

A focused concern: assessment and, where appropriate, a short treatment programme with agreed goals.
Limited progress or additional questions: review of the approach and consideration of broader assessment or referral.
A complex care pathway: discussion of additional coordination through Enlace Care.

These are possible routes, not compulsory stages. If the intake identifies a need for other medical care or immediate coordination, you do not have to complete a treatment programme first.

Future practice cases will illustrate how these decisions are made. Individual experiences can explain the approach, but do not predict another person’s outcome.

What can you expect from IMC Utrecht?

You can expect a discussion of your concerns, realistic treatment goals and an agreed point at which to review progress.

Our aim is to help you understand the proposed approach and decide whether it fits your needs. Where treatment is not appropriate or additional expertise is needed, we discuss the alternatives.

For more information about symptoms that remain unexplained after medical tests, read our article:

From Back Pain to System: Osteopathy and kPNI for High‑Performing Expats

For a closer look at broader support, explore the Enlace Care articles on the Medical Strategist’s role and the use of the kPNI perspective.

Enlace Personal Care: IMC treats. Enlace Care directs.

Book an initial appointment

Would you like to discuss whether an assessment at IMC Utrecht is appropriate for you?

During an initial appointment, we review your concerns, relevant medical history and possible next steps. From there, we agree on the level of support that fits your situation.

Plan your intake

If symptoms change, become significantly worse or new symptoms develop, contact your GP or treating clinician. Seek urgent medical help for severe acute symptoms.