If you have been suffering from chronic unexplained pain in your abdomen, lower back or pelvis F-act in Enkhuizen, the Netherlands, is the place to come to get help with your problems. F-act stands for ‘Effect’

Our clinic is specialised in the diagnosis and treatment of chronic pain in the abdomen, lower back and pelvic region. We look for solutions to complex causes of pain. We often have patients who have had extensive medical examinations but where no clear reason for their pain has been found. By looking at the problem from several different points of view we often find that the pieces of the puzzle fall into place. This type of pain, often called Chronic Pelvic Pain Syndrome, or CPPS, can occur in both men and women.

Our professionals make use of the latest scientific research in this field and have a wide network of contacts with other specialists both in the Netherlands and abroad. The core principles of our clinic are Respect, Care, Quality and Autonomy

F-act is located in Enkhuizen, a small historic town in the Netherlands, one hour by train from Schiphol Amsterdam Airport. A 'bed and breakfast' can be found within walking distance of the clinic (5 min). Patients, both male and female, from all over the world have found us, so can you!


Medical diagnoses of pain in the abdomen, lower back and pelvis often do not take into account potential problems with the muscles, ligaments, nerves and joints in this area. In fact, these body elements often play an essential role in the underlying cause of the pain. F-act has detailed knowledge of the intimate relationship between the organs and musculo-skeletal structure and carefully considers this relationship - which other specialists sometimes ignore.


We make discussion of pain in this vulnerable and private part of our bodies something that it is OK to talk about. After a careful diagnosis we, together with you, devise an appropriate treatment strategy. We teach people how to recognise their pain at an early stage, we diagnose and treat their pain and we also give them the tools to treat themselves.

How does the approach of the Pain Clinic differ from that of a normal Pelvic Physiotherapy Centre?

From the beginning of the nineteen nineties Fetske Hogen Esch has looked at ways of providing a better quality of life to patients suffering from Chronic Pelvic Pain. She has done this through:
•    following many specialised courses
•    building up an (inter)national network of specialists who share her passion
•    making in-depth studies of complex cases

Through the relationships of deep trust she has with the many patients she has examined and treated, she has become a real specialist in her field. A specialist with knowledge and understanding which far surpasses that of most pelvic physiotherapists. For over 20 years she has been teaching Pelvic Floor Physiotherapy, with emphasis on pain, to physiotherapy students in the Netherlands and abroad.

You don’t need a referral from your doctor to have an examination or treatment at our clinic. However, it is useful if you inform your doctor that you have sought our help. Existing information about your condition is very important to us.