Acupuncture: a doctor’s approach

Acupuncture is one of the most studied therapies in integrative medicine, with a substantial evidence base across pain, mental health, fatigue, and inflammatory conditions. This page sets out how I use it in clinic, how my approach differs from how acupuncture is usually practised, and how it sits alongside conventional medicine, Traditional Chinese Medicine, and Ayurveda for people with chronic or unresolved symptoms.

This page is for people who are considering acupuncture, but want to understand what it actually involves, and what separates one approach from another, before booking anything.

It is for you if you have chronic pain, tension, or sensitisation, if you have anxiety or a nervous system that stays on high alert, if your sleep does not restore you, if you have digestive symptoms tied to stress, or fatigue that rest does not fix. It is also for you if you have already tried acupuncture elsewhere, found it did a little, and wondered whether that was all it could do.

It is not for emergencies, crisis care, or situations that need urgent conventional treatment. If your symptoms are new, severe, or rapidly worsening, please contact your GP, go to an emergency department, or call the appropriate Maltese service first.

I work as a doctor with training in conventional medicine, Traditional Chinese Medicine, and Ayurveda. Acupuncture is one of the tools I use, placed inside a wider clinical plan. What follows is how I use it, what it can help, and what it cannot.

If something here speaks to you and you would like a quiet first contact, you can reach me on WhatsApp. You do not need a polished summary in the message.

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The way I work with acupuncture

Most acupuncture in Malta is brief. A few needles, often placed where it hurts, left in for a short time, then removed. That is the session. Sometimes a little electroacupuncture or cupping is added. For straightforward muscular pain, that approach has its place.

It is not what I do, and the difference matters most for people whose problems have not resolved with that kind of treatment.

I trained first as a medical doctor, then in Chinese medicine, then in Ayurveda. I read the body through all three at once. Pulse diagnosis tells me which meridians are involved. The modern science tells me which points act on which system, and why. Ayurveda adds the marma points, which were needled in their own tradition long before the West paid attention, a part of Ayurveda that is rarely known because it is so often reduced to massage and wellness. I use that combined picture to decide where to needle and why, rather than simply treating the site of pain.

A session with me is also not half an hour. I can run electroacupuncture through more than one channel at the same time. I can use scalp acupuncture to reach the whole body from the head alone. And I combine needling, in the same treatment, with myofascial work, subconscious work, cupping, red light, personalised IV support, oils, and steam, among other tools, each chosen for the pattern in front of me rather than applied as a fixed routine.

The aim is meaningful change, as quickly as the body safely allows. I am not interested in a slow series of weekly sessions where you improve a little each time and keep coming back. Straightforward pain, and fertility, are relatively simple work. What I focus on are the complicated, multi-system problems that other approaches have not been able to move.

This is acupuncture kept faithful to the depth it was always meant to have, and brought up to what the modern patient actually needs.

What ancient systems were describing

For thousands of years, Chinese medicine has worked with the idea that an intelligent life force, Qi, flows through channels called meridians, connecting organs and influencing physical and psychological wellbeing. Ayurveda has a parallel concept, prana, life force energy flowing through nadis. These were clinical frameworks, used to organise diagnosis and treatment, refined over centuries of practice.¹

Acupuncture, and marma therapy, the Ayurvedic equivalent, both work by stimulating specific points along these channels to preserve or restore the free flow of this energy. For most of medical history, this was where the explanation stopped.

What modern science has begun to add is a mechanistic layer that translates these descriptions into anatomical and physiological terms most clinicians recognise.

Fascia and the body’s electrical network

The most interesting recent development in acupuncture research has been the work on fascia.

Fascia is the connective tissue that encases every nerve, muscle, and organ in the body. It was largely ignored in conventional medicine for decades, treated as inert packaging. We now know it is anything but inert. Fascia is composed largely of collagen, which has piezoelectric properties, meaning it generates electrical charge when mechanically stressed.² This matters because the body’s processes are fundamentally electrical, from nerve impulses, to the heart’s pacemaker, to the membrane potentials that keep cells alive.

Fascia, in other words, is an electrical web that connects the entire body.

A significant finding for acupuncture came from work showing approximately 80 percent correspondence between traditional meridians and connective tissue planes. The connective tissue planes that overlap with meridians have lower electrical resistance, meaning they conduct electricity more efficiently than surrounding tissue.³ This is one plausible mechanism by which inserting needles at specific points can produce effects far beyond the local site of insertion.

Anatomical characterisation of acupuncture points has also shown distinctive features at the cellular and biophotonic levels.⁴ The body, viewed through this lens, looks much more like the integrated electrical network ancient medicine described, and much less like the collection of separate organs conventional medicine tends to assume.

What the clinical evidence actually shows

The evidence base for acupuncture is now broad enough to be unambiguous in several areas.

Anxiety. Multiple systematic reviews have shown that acupuncture reduces anxiety symptoms, with mechanistic evidence linking the effect to autonomic nervous system regulation.⁷

Depression. Systematic reviews and meta-analyses have shown meaningful improvement in depressive symptoms, with effect sizes comparable to or exceeding several pharmacological options.⁶

Insomnia. Meta-analyses have shown clinically meaningful improvement in sleep quality and sleep latency.¹¹

Fibromyalgia. Meta-analyses have shown acupuncture reduces pain and improves quality of life in fibromyalgia patients, where conventional pharmacological options often reach a ceiling.⁸ Most people I see with fibromyalgia have been on several medications without resolution.

Chronic fatigue syndrome. A network meta-analysis has demonstrated benefit for chronic fatigue syndrome, including improvements in fatigue scores and quality of life.⁹

Chronic pain. A large individual patient data meta-analysis covering over 20,000 patients across multiple chronic pain conditions found acupuncture produces clinically meaningful effects beyond placebo, sustained over 12 months.⁵ This is one reason NICE in the UK recommends it for chronic primary pain.

Cancer-related fatigue. Effective enough that it has been integrated into many oncology supportive care protocols.¹⁰

Other documented areas. Weight regulation,¹² chemotherapy-induced nausea and vomiting,¹³ ischaemic stroke rehabilitation,¹⁴ primary dysmenorrhoea,¹⁵ menopause-related symptoms,¹⁶ and immune function.¹⁷

These are mainstream meta-analyses in mainstream journals, accumulated over the last fifteen to twenty years.

How acupuncture works mechanistically

The mechanistic picture is now well documented.

Autonomic nervous system regulation. Acupuncture modulates the autonomic nervous system, increasing parasympathetic tone, improving heart rate variability, and shifting the body out of sympathetic dominance.¹⁸ This is one of the central mechanisms by which it influences digestion, hormonal regulation, and the stress response.

Blood flow and circulation. Acupuncture stimulates nitric oxide production, which produces vasodilation and enhances circulation in the skin, muscles, and brain. Improved cerebral blood flow has been demonstrated in studies of stroke rehabilitation and cognitive recovery.^{19, 20}

Endogenous opioids and neuropeptides. Acupuncture stimulates the release of endorphins, enkephalins, and dynorphins, alongside non-opioid compounds including serotonin, norepinephrine, oxytocin, and ATP. These contribute to pain modulation and mood regulation, and help explain why effects can be felt in parts of the body distant from the needle site.²¹

Anti-inflammatory effects. Acupuncture promotes anti-inflammatory cytokine production, reducing systemic inflammation in both acute and chronic conditions.²¹

These mechanisms are not exclusive. Acupuncture often works through several pathways at once, which is part of why it can help conditions that span more than one body system.

Neuroacupuncture and electroacupuncture

Two extensions of traditional acupuncture deserve specific mention, because they significantly expand what is clinically possible, and because they are central to how I work.

Neuroacupuncture combines traditional acupuncture points with modern neuroanatomy and neurophysiology. It targets specific brain regions through scalp acupuncture, with research showing benefit in multiple sclerosis,²² stroke rehabilitation,²³ autism spectrum disorders,²⁴ and complex regional pain syndrome.²⁵ The mechanism appears to involve improved cerebral blood flow, reduced neuroinflammation, and promotion of neural regeneration.²⁶ This is a relatively new integration between Eastern technique and Western neuroscience, and the early evidence is strong enough that I expect it to become far more widely used over the next decade.

Electroacupuncture extends standard acupuncture by adding a controlled electrical current through the needles, producing deeper and more sustained stimulation. The evidence is particularly strong in chronic pain,²⁷ inflammatory conditions,²⁸ and neurological disorders.²⁹ In my own work, electroacupuncture is the technique I reach for when a patient needs a deeper level of intervention than traditional acupuncture alone provides, particularly in chronic pain and nervous system dysregulation.

How I use acupuncture clinically

Acupuncture is most useful when it is chosen for the right reason.

It can be used for local problems, pain around a joint, muscle tension, headaches, a specific area of inflammation. But its wider value is often seen in people whose symptoms involve regulation rather than one isolated structure. These are the cases where pain, sleep, digestion, mood, fatigue, and stress physiology are connected.

So the first question is not simply, “can acupuncture help this symptom?” The better question is, “what system is this symptom part of?”

Lower back pain may be mainly mechanical. It may also be linked to poor sleep, chronic muscle guarding, stress, inflammation, or nervous system sensitisation. Anxiety may be primarily psychological in some cases, but in others it is strongly linked to autonomic overactivation, poor sleep, gut disruption, or a body that has stayed in a protective state too long. Fibromyalgia-type pain may sit alongside fatigue that rest does not fix, emotional depletion, or several overlapping drivers at once.

This is also why isolated acupuncture sessions can help some problems but barely touch others. If the wider drivers are not addressed, the effect is often temporary. When the right person is selected and the treatment sits inside a clear clinical picture, acupuncture becomes a way of influencing pain, regulation, circulation, and recovery at the same time.

It is also important to be clear about what acupuncture is not. It is not a substitute for appropriate investigation. It should not be used to avoid red flags, delay necessary treatment, or explain away symptoms that need conventional assessment. In chronic, multi-system cases, good acupuncture does not begin with needles. It begins with clinical judgement.

Patterns acupuncture often helps with

The patterns I most often use acupuncture for, as part of a wider integrative plan:

chronic pain with tension, guarding, or sensitisation
anxiety, nervous overload, poor stress recovery, or a system stuck in sympathetic dominance
sleep that does not restore, linked to nervous system overactivity
digestive symptoms and IBS-style patterns influenced by stress physiology
widespread pain or fibromyalgia-type patterns
chronic fatigue where regulation, circulation, or recovery capacity appear impaired
headaches and migraine patterns
inflammatory or immune-related patterns where the body is not settling
neurological recovery, where neuroacupuncture has a particular role

Two people may share the same symptom and need completely different treatment. That is why the diagnosis comes first, and the needles follow from it.

Who this approach is most suitable for

This approach may be especially relevant if you:

have chronic pain or symptoms that have not fully resolved with other treatment
have tried brief acupuncture elsewhere and felt it did not reach the problem
have been told your tests are normal, but you still do not feel right
feel your symptoms are connected, but nobody has joined the dots
have pain, fatigue, poor sleep, anxiety, stress, or recurring inflammatory patterns
want a natural approach, but still want medical judgement and safety
want meaningful change rather than an open-ended series of sessions

This may not be the right fit if you are looking for emergency care, a quick fix that bypasses diagnosis, a guaranteed result, or a replacement for necessary medical treatment.

If you simply want someone to sanity-check whether this kind of acupuncture is even the right category for what you are carrying, that is an acceptable reason to write.

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Considering acupuncture

If you are considering acupuncture, there are several options, and the right one depends on what you are dealing with. For chronic, complex, or connected symptoms across pain, sleep, digestion, stress, and energy, acupuncture works best inside a fuller clinical picture.

In my work, it is one tool within a picture built through three medical lenses, used together, by the same doctor, in the same consultation: conventional medicine, Traditional Chinese Medicine, and Ayurveda. This sits inside the wider frame of integrative medicine.

Frequently asked questions

Can acupuncture be a natural approach to chronic pain?

Yes. Acupuncture can ease both acute and chronic pain by working with the body’s own pain-relieving mechanisms and supporting healing. Part of how it does this is by releasing endorphins, the body’s natural painkillers. In my clinic I rarely use it on its own: I combine it with other evidence-based modalities to reduce pain more effectively, chosen after a proper assessment of what is driving it.

Are there natural alternatives to painkillers for long-term pain?

Yes, and not only for long-term pain. Natural ways to ease pain can include a healthy diet, exercise, yoga and acupuncture, among others. Which of these helps depends on what is actually driving the pain, whether that is the nervous system, poor sleep, inflammation or something else. A natural approach like mine usually combines several of these, chosen to treat the wider pattern rather than the pain in isolation, while keeping conventional diagnosis and safety in view.

What can acupuncture actually treat, and what is it good for?

Acupuncture can help with pain relief, digestion, sleep, fertility, immune function, fibromyalgia, nausea and addiction, among others, and the evidence for several of these is strong, as set out with references above. In practice, I find it most useful where a number of symptoms are connected. Acupuncture is a whole system of medicine, so rather than treating a single Western condition, Chinese medicine looks for the pattern beneath the symptoms, how they link together, and uses the needles to target that pattern rather than the label.

Is acupuncture available in Malta?

Yes, I offer medical acupuncture, electroacupuncture and scalp acupuncture in Swieqi. One thing worth knowing before you book anywhere: acupuncture varies widely with the skill and approach of the practitioner, which is the focus of the next question.

Does acupuncture actually work, or is it placebo?

The evidence shows acupuncture performs better than placebo for several conditions, including chronic pain, anxiety, insomnia and fibromyalgia, with mechanisms in the nervous system, circulation and inflammation now well documented. The placebo effect itself is more complex than it sounds, and worth respecting, but the benefit here goes beyond it. The evidence is summarised, with references, above.

How is your acupuncture different from other clinics?

Most acupuncture is brief and focused on the site of pain. I use it inside a fuller diagnosis that draws on conventional medicine, Chinese medicine pulse diagnosis, and Ayurveda, and I combine it with electroacupuncture, scalp acupuncture, and other modalities in longer, adapted sessions. The aim is meaningful change rather than an open-ended series of weekly visits.

What is electroacupuncture?

Electroacupuncture combines traditional acupuncture with mild electrical stimulation through the needles to enhance its effect. I use it in a range of situations, including more complex, multi-system cases, not only chronic pain and nervous-system dysregulation.

What is scalp acupuncture or neuroacupuncture?

Scalp acupuncture combines traditional points with modern neuroanatomy to target specific brain regions. It has a particular role in neurological recovery and complex, multi-system patterns.

Does acupuncture hurt?

The needles are very fine and the sensation is usually mild, far gentler than the needles used for injections. I would add one honest point: what matters most is the result. Meaningful change sometimes asks a little discomfort of us, and in my view that can be a fair trade for getting better. Most people find the sessions very tolerable.

Can acupuncture be combined with conventional medical care?

Yes. It is used alongside appropriate conventional care, never as a replacement for it, and I am glad to work with your other doctors so that treatment is as safe and effective as possible.

How do I book acupuncture?

Start by finding the practitioner you feel most comfortable with, understand how they work, and decide whether you believe they are the right person to help you. Then get in touch by whatever method suits them. With me, that is a WhatsApp message, and if it seems a fit we arrange an assessment from there.

The next step

If you have read this far and you agree with this way of working, feel free to send a WhatsApp to assess suitability.

Dr Shehan Wijesingha, MD, M.TCM, DipAP, BMedSci, CPT. Vice President of the Association of Ayurvedic Professionals UK.

Medical disclaimer: This page is for educational purposes. It is not a substitute for individual medical assessment, diagnosis, or treatment. Acupuncture should be performed by a properly qualified practitioner. Do not alter or stop medication, or begin new treatment, based on this page alone. If you are in crisis, contact your GP, go to an emergency department, call a crisis line, or contact the appropriate Malta-based service. Consult a qualified clinician who can evaluate your specific situation.

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