The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain

Journal of Complementary Therapies in Health ISSN 2975-9323 |eISSN 2975-9552 Journal of Complementary Therapies in Health 2025:3(3). doi:10.5281/zenodo.17533392 institutoptc.com/journal-complementary-therapies Review The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain. Samuel Magalhães1*, Ana Rita Gonçalves1, Angie Paola Estupiñan1, Diogo Augusto Ribeiro1, Bruna Pereira dos Santos1, Ana Carolina Gomes1, and Leandro Araújo1. 1 IPN – Portuguese Institute of Naturology, Porto, Portugal. * Correspondence: sam[email protected]m Abstract Background: Chronic pain affects approximately 20–30% of the global adult population and is associated with substantial physical, psychological, and socio-economic burdens. Conventional pharmacological treatments often provide limited relief and may carry adverse effects. Yamamoto New Scalp Acupuncture (YNSA) is a microsystem acupuncture technique developed in 1973, which has been proposed as a precise, non-pharmacological approach for managing chronic pain. Objective: This article aims to review the theoretical foundations, proposed mechanisms, and clinical evidence supporting the use of YNSA in chronic pain management, and to identify gaps for future research. Methods: A narrative review of the literature was conducted, focusing on clinical studies, mechanistic investigations, and theoretical models of YNSA. Results: YNSA employs a detailed somatotopic microsystem, where specific scalp areas correspond to body regions and organs. Clinical studies have demonstrated its efficacy in various conditions, including degenerative osteoarthritis, chronic low back pain, headaches, migraines, myofascial pain, and post-stroke rehabilitation. Mechanistically, YNSA may modulate pain through activation of somatosensory afferents, engagement of descending inhibitory pathways, and neuroplastic changes. The fascia hypothesis provides a plausible explanation for systemic effects via mechanotransduction and biochemical signalling. Recent studies, including randomized crossover trials and neuroimaging research, support its analgesic efficacy, functional improvements, and safety profile. The current evidence is limited by small sample sizes, heterogeneous methodologies, and the lack of standardised treatment protocols. Outcomes are heavily dependent on practitioner expertise, and mechanistic understanding remains incomplete. Conclusion: YNSA represents a promising, precise acupuncture microsystem with demonstrable analgesic effects and potential to enhance function and quality of life in patients with chronic pain. Further high-quality, standardised clinical trials and mechanistic studies are required to consolidate its scientific foundation and facilitate integration into multidisciplinary pain management strategies. Keywords: Chronic pain; Yamamoto New Scalp Acupuncture; YNSA; Scalp acupuncture; Neuroplasticity; Fascia; Complementary therapies. 1. Background Chronic pain affects approximately 20-30% of the global adult population, with a higher prevalence among older adults. This estimate is supported by multiple sources 1-4, including the World Health Organization 5. Chronic pain is frequently associated with diverse aetiologies such as arthritis, diabetes, and cancer, and it has substantial conseCitation: Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain. Journal of Complementary Therapies in Health. 2025;3(3) 10.5281/zenodo.17533392 Academic Editor: Jorge Rodrigues Received: 17 September 2025 Reviewed: 29 September 2025 Revised: 25 October 2025 Accepted: 28 October 2025 Published: 5 November 2025 Publisher’s Note: IPTC stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: ©2025 by the authors. Submitted for open access publication under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Journal of Complementary Therapies in Health 2025: 3(3). 2 of 9 Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain doi:10.5281/zenodo.17533392 quences for both patients and society, leading to increased utilisation of healthcare resources 6. Regarding conventional treatments, pharmacological therapies often demonstrate limited efficacy and may be accompanied by significant adverse effects 6,7. Within this context, YNSA may emerge as a promising approach for chronic pain relief, currently being studied for its clinical outcomes 8-10. This stems from its dual diagnostic and therapeutic approach. The identification of treatment points is performed through palpation of specific scalp areas (“points”) that reflect the patient’s condition, enabling a highly targeted intervention 11,12. Stimulation of these points, typically using fine needles, aims to restore the flow of vital energy (Qi) and promote physiological balance, resulting in pain relief and functional improvement through the modulation of nociceptive signalling 13,14. 2. Foundations YNSA, introduced by Dr Toshikatsu Yamamoto in 1973 12, is distinguished from traditional Chinese acupuncture by its unique and systematic approach. YNSA is based on a detailed somatotopic microsystem, in which specific areas of the scalp correspond to different parts of the body, organs, and physiological functions (Figure 1 and Figure 2). Figure 1. Somatotopic maps of YNSA. (A) Representation of the basic points (e.g. A, B, C), associated with the locomotor system. (B) Representation of the sensory and cerebral points, related to the sensory organs and neurological functions. Journal of Complementary Therapies in Health 2025: 3(3). 3 of 9 Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain doi:10.5281/zenodo.17533392 Figure 2. Representation of the “Y” points – strong Yin area. In contrast to traditional Chinese acupuncture (TCA), YNSA places particular emphasis on diagnosis through palpation. The practitioner palpates specific cranial regions to identify reactive points, which indicate dysfunction or pain in corresponding areas of the body. YNSA points are classified as basic points (e.g. A, B, C, D, E) and sensory points, each with specific therapeutic indications 11,15. The selection of points for treatment is guided by the patient’s response to palpation, giving YNSA a individualised and precise character. Table 1. Main characteristics of YNSA vs. TCA YNSA TCA Origin Japan, 1973 (Dr. Toshikatsu Yamamoto) China (ancient, millennia-old tradition) Area of Application Exclusively on the scalp (microsystem) Entire body (macrosystem) Diagnostic Method Palpation of the neck and abdomen Pulse diagnosis, tongue observation, palpation, and patient interview Point System Somatotopic points (body-mapping system) Fixed points along energetic meridians Needle Depth Superficial, subdermal insertion Variable, ranging from superficial to deep Main Indications Pain and neurological conditions (e.g. stroke) Broad range of conditions (internal, painrelated, etc.) Effect Often rapid, sometimes immediate Gradual or immediate, depending on the condition and technique Journal of Complementary Therapies in Health 2025: 3(3). 4 of 9 Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain doi:10.5281/zenodo.17533392 3. Proposed Mechanisms Although the precise physiological mechanisms of YNSA remain under investigation, current evidence suggests a multifaceted mode of action. Stimulation of scalp points appears to engage somatosensory afferents at the scalp/meningeal interface, which may in turn influence neuronal activity and modulate cerebral blood flow in brain regions involved in pain perception and motor control 16,17. In parallel, YNSA appears to engage descending pain-inhibitory systems, potentially via endogenous opioids (endorphins, dynorphins) and monoamine (serotonin, noradrenaline) pathways 18,19. Collectively these effects may result in attenuation of nociceptive signalling and functional improvement. Additionally, repeated stimulation may induce neuroplastic changes in the brain, reorganising neural networks and improving function in patients with neurological conditions such as stroke 20,21. An emerging hypothesis proposes that the fascia, a continuous network of connective tissue, acts as a conductor of acupuncture effects 22. Stimulation of YNSA points may interact with this network, altering its viscoelastic properties and cellular signalling, which in turn may modulate pain perception and promote healing. 4. Clinical Evidence The effectiveness of YNSA in the management of chronic pain has been increasingly supported by clinical research across a variety of conditions. Several studies have highlighted its analgesic potential and functional benefits, suggesting that YNSA may represent a valuable adjunct to conventional pain therapies. A pilot study by Allam et al. 23 investigated the application of YNSA in patients with degenerative osteoarthritis, demonstrating a significant reduction in pain following a single treatment session. Participants reported marked improvements in subjective pain scores, with effects noted immediately after intervention and persisting for several days post-treatment. These findings provide preliminary evidence for YNSA’s rapid analgesic potential in musculoskeletal conditions, particularly in osteoarthritic populations. In patients with chronic low back pain, Camilotti et al. 9 conducted a clinical study evaluating YNSA’s efficacy and reported a substantial decrease in pain intensity, alongside improvements in functional outcomes and patient-reported quality of life. The study underscored YNSA’s capacity to target specific somatic regions corresponding to painful areas, supporting the technique’s underlying precision and individualized diagnostic approach. The application of YNSA has also been explored in the treatment of headaches and migraines. Rezvani et al. 24 compared YNSA with traditional acupuncture approaches and found comparable reductions in headache frequency, duration, and severity. Importantly, patients receiving YNSA reported enhanced tolerability and satisfaction, suggesting that the technique may provide a clinically meaningful alternative for patients who experience suboptimal outcomes with conventional acupuncture protocols. Further evidence comes from Correia et al. 25, who successfully employed YNSA in managing chronic myofascial pain in the head and neck region. The study highlighted not only reductions in pain intensity but also improvements in muscular tension and overall quality of life, reinforcing the notion that YNSA can exert both local and systemic analgesic effects. More recently, Dutra et al. 26 evaluated the use of YNSA among nursing students experiencing chronic musculoskeletal discomfort. Their findings demonstrated a significant reduction in pain scores and a measurable enhancement in functional outcomes, including daily activity performance and overall wellbeing. These results suggest that YNSA may be beneficial in populations with repetitive strain or occupational musculoskeletal pain. Beyond pain management, YNSA has also shown promising effects in post-stroke rehabilitation. Clinical observations and pilot studies indicate improvements in motor function, mobility, and quality of life, highlighting the potential role of YNSA in facilitating neuroplasticity and functional recovery after neurological injury 21. Journal of Complementary Therapies in Health 2025: 3(3). 5 of 9 Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain doi:10.5281/zenodo.17533392 However, more clinical studies have recently provided compelling evidence for the efficacy of YNSA in treating various chronic pain conditions. For example, a 2024 observer-blind randomized crossover trial by Kaneko et al. 27 investigated the application of YNSA in healthy participants experiencing neck pain and shoulder stiffness. The study demonstrated significant improvements in pain reduction and increased range of motion, suggesting that YNSA can effectively address musculoskeletal discomfort through targeted scalp acupuncture. In the realm of chronic low back pain, a 2025 study by Gao et al. 28 compared the efficacy of acupuncture, including YNSA, with traditional treatments. The results indicated that acupuncture, particularly when combined with complementary therapies, significantly alleviated pain and improved functional outcomes, underscoring the role of YNSA in comprehensive pain management strategies. Also important, scalp acupuncture may produce improvements in overall well-being and daily functioning of patients, highlighting its holistic benefits 29. 5. Discussion YNSA represents an innovative and precise approach to the management of chronic pain, distinguished by its somatotopic organisation and diagnostic palpation-based methodology. The underlying mechanisms of its analgesic and functional effects are increasingly being examined through emerging neurophysiological and biomechanical models. Among these, the fascia hypothesis provides a particularly compelling explanation, proposing that fascia functions as a dynamic, signal-transducing system capable of mediating local and systemic therapeutic effects 22,30. Fascia, a continuous three-dimensional connective tissue network, is richly innervated and mechanically responsive. Needle insertion during YNSA generates mechanical and sensory stimulation, initiating mechanotransduction processes that activate fibroblasts, nociceptors, and interstitial nerve endings 31,32. This interaction leads to alterations in the viscoelastic properties of the fascia and triggers the local release of bioactive molecules such as adenosine, which exerts well-documented antinociceptive effects 33-35. These local mechanisms may converge with central modulation, influencing nociceptive processing at the spinal and supraspinal levels. The anatomical continuity of the fascial system also provides a plausible substrate for the acupuncture meridian network, supporting the hypothesis that stimulation at one point can influence distant body regions through fascial, neural, and biochemical connectivity 36,37. Within this framework, YNSA’s scalp stimulation may activate afferent pathways that interact with central structures responsible for pain modulation and sensorimotor control, aligning with current neuroimaging findings that associate scalp acupuncture with altered cerebral blood flow and cortical activation patterns. Despite these mechanistic insights, the current evidence base remains limited. Most available studies are small-scale and heterogeneous in design, often lacking rigorous randomisation or standardised protocols. Furthermore, practitioner-dependent variability in palpation-based diagnosis presents challenges for reproducibility and cross-study comparison 11. Addressing these methodological limitations through well-designed, multicentre randomised controlled trials will be essential to validate the therapeutic consistency of YNSA. Complementary use of functional neuroimaging and neurochemical biomarkers could further elucidate its mechanisms, bridging the gap between clinical efficacy and physiological evidence. Taken together, these findings highlight YNSA as a promising yet underexplored therapeutic modality. Its integrative potential lies in harmonising traditional concepts of energy flow with modern understandings of neurophysiology and connective tissue dynamics. This alignment supports a broader vision of pain management that encompasses both somatic and systemic regulation. Journal of Complementary Therapies in Health 2025: 3(3). 6 of 9 Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain doi:10.5281/zenodo.17533392 While encouraging, these observations must be interpreted with caution. The methodological diversity and limited sample sizes across existing studies restrict the generalisability of findings. A structured evaluation of these limitations, along with potential research directions, is therefore warranted to consolidate the clinical and scientific foundation of YNSA. 5.1. Limitations and Future Perspectives Despite the encouraging therapeutic outcomes reported, YNSA research currently faces several important limitations. Many clinical studies involve small sample sizes and heterogeneous methodologies, which restrict the statistical power and generalisability of their findings. The absence of standardised treatment protocols, including point selection, stimulation parameters, and session frequency, further complicates cross-trial comparison and meta-analytic synthesis. Additionally, as YNSA relies heavily on palpation-based diagnostic sensitivity, outcomes are significantly influenced by the practitioner’s training and clinical experience 11. To enhance methodological robustness, large-scale, multicentre randomised controlled trials with clearly defined intervention parameters are essential. Incorporating functional neuroimaging techniques, such as fMRI and PET, may help clarify the specific neural circuits and cortical regions modulated by YNSA, thereby providing objective physiological correlates to its clinical effects. Furthermore, targeted studies exploring the role of the fascial system could expand understanding of its contribution to mechanotransduction and systemic regulation. Future research should prioritise the standardisation of diagnostic and therapeutic protocols, along with the development of competency-based training frameworks to improve inter-practitioner reliability. Collectively, these efforts will be crucial for establishing YNSA as a reproducible, evidence-based intervention within integrative pain management. By addressing these research and methodological gaps, future investigations can consolidate the scientific foundation of YNSA and define its precise role within multidisciplinary approaches to chronic pain treatment. 6. Conclusion YNSA constitutes a refined and evidence-emerging microsystem with significant potential in the management of chronic pain. Accumulating clinical data support its analgesic efficacy and favourable safety profile. Further high-quality studies and protocol standardisation are essential to consolidate its scientific foundation and facilitate its integration into multidisciplinary pain management frameworks. Credit author statement: Conceptualisation, S.M.; Methodology, S.M.; Validation, S.M.; Formal analysis, S.M.; Investigation, S.M., and A.R.G.; Writing – Original Draft, S.M., and A.R.G.; Writing – Review & Editing, S.M., A.R.G., A.P.E., D.A.R., B.P.S., A.C.G., and L.A.; Visualisation, S.M. and A.R.G.; Project administration, S.M. All authors have read and agreed to the published version of the manuscript. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Conflict of Interest: The authors declare that there are no conflicts of interest. Institutional Review Board Statement: Not applicable. Informed Consent Statement: Not applicable. Journal of Complementary Therapies in Health 2025: 3(3). 7 of 9 Magalhães S., Gonçalves A.R., Estupiñan A.P., Ribeiro D.A., dos Santos B.P., Gomes A.C., Araújo L. The Yamamoto New Scalp Acupuncture (YNSA) as a Precision Technique in the Management of Chronic Pain doi:10.5281/zenodo.17533392 Data Availability Statement: The original contributions presented in this study are included in the article. Further inquiries can be directed to the corresponding author. References 1. Jackson T, Thomas S, Stabile V, Shotwell M, Han X, McQueen K. 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