Jou nal o Complemen a y The apies in Heal h
ISSN 2975-9323 |eISSN 2975-9552
Jou nal o Complemen a y The apies in Heal h 2025:3(3). doi:10.5281/zenodo.17533392 ins i u op c.com/jou nal-complemen a y- he apies
Re iew
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision
Technique in he Managemen o Ch onic Pain.
Samuel Magalhães1*, Ana Ri a Gonçal es1, Angie Paola Es upiñan1, Diogo Augus o Ribei o1,
B una Pe ei a dos San os1, Ana Ca olina Gomes1, and Leand o A aújo1.
1 IPN – Po uguese Ins i u e o Na u ology, Po o, Po ugal.
* Co espondence: sam[email p o ec ed]m
Abs ac
Backg ound: Ch onic pain a ec s app oxima ely 20–30% o he global adul popula ion and is asso-
cia ed wi h subs an ial physical, psychological, and socio-economic bu dens. Con en ional pha -
macological ea men s o en p o ide limi ed elie and may ca y ad e se e ec s. Yamamo o New
Scalp Acupunc u e (YNSA) is a mic osys em acupunc u e echnique de eloped in 1973, which has
been p oposed as a p ecise, non-pha macological app oach o managing ch onic pain.
Objec i e: This a icle aims o e iew he heo e ical ounda ions, p oposed mechanisms, and clini-
cal e idence suppo ing he use o YNSA in ch onic pain managemen , and o iden i y gaps o
u u e esea ch.
Me hods: A na a i e e iew o he li e a u e was conduc ed, ocusing on clinical s udies, mecha-
nis ic in es iga ions, and heo e ical models o YNSA.
Resul s: YNSA employs a de ailed soma o opic mic osys em, whe e speci ic scalp a eas co espond
o body egions and o gans. Clinical s udies ha e demons a ed i s e icacy in a ious condi ions,
including degene a i e os eoa h i is, ch onic low back pain, headaches, mig aines, myo ascial
pain, and pos -s oke ehabili a ion. Mechanis ically, YNSA may modula e pain h ough ac i a ion
o soma osenso y a e en s, engagemen o descending inhibi o y pa hways, and neu oplas ic
changes. The ascia hypo hesis p o ides a plausible explana ion o sys emic e ec s ia mecha-
no ansduc ion and biochemical signalling. Recen s udies, including andomized c osso e ials
and neu oimaging esea ch, suppo i s analgesic e icacy, unc ional imp o emen s, and sa e y
p o ile. The cu en e idence is limi ed by small sample sizes, he e ogeneous me hodologies, and
he lack o s anda dised ea men p o ocols. Ou comes a e hea ily dependen on p ac i ione ex-
pe ise, and mechanis ic unde s anding emains incomple e.
Conclusion: YNSA ep esen s a p omising, p ecise acupunc u e mic osys em wi h demons able
analgesic e ec s and po en ial o enhance unc ion and quali y o li e in pa ien s wi h ch onic pain.
Fu he high-quali y, s anda dised clinical ials and mechanis ic s udies a e equi ed o consolida e
i s scien i ic ounda ion and acili a e in eg a ion in o mul idisciplina y pain managemen s a e-
gies.
Keywo ds: Ch onic pain; Yamamo o New Scalp Acupunc u e; YNSA; Scalp acupunc u e; Neu o-
plas ici y; Fascia; Complemen a y he apies.
1. Backg ound
Ch onic pain a ec s app oxima ely 20-30% o he global adul popula ion, wi h a
highe p e alence among olde adul s. This es ima e is suppo ed by mul iple sou ces 1-4,
including he Wo ld Heal h O ganiza ion 5. Ch onic pain is equen ly associa ed wi h
di e se ae iologies such as a h i is, diabe es, and cance , and i has subs an ial conse-
Ci a ion: Magalhães S., Gonçal es
A.R., Es upiñan A.P., Ribei o D.A.,
dos San os B.P., Gomes A.C., A aújo
L. The Yamamo o New Scalp Acu-
punc u e (YNSA) as a P ecision Tech-
nique in he Managemen o Ch onic
Pain. Jou nal o Complemen a y
The apies in Heal h. 2025;3(3)
10.5281/zenodo.17533392
Academic Edi o : Jo ge Rod igues
Recei ed: 17 Sep embe 2025
Re iewed: 29 Sep embe 2025
Re ised: 25 Oc obe 2025
Accep ed: 28 Oc obe 2025
Published: 5 No embe 2025
Publishe ’s No e: IPTC s ays neu al
wi h ega d o ju isdic ional claims in
published maps and ins i u ional a -
ilia ions.
Copy igh : ©2025 by he au ho s.
Submi ed o open access publica-
ion unde he e ms and condi ions
o he C ea i e Commons A ibu ion
(CC BY) license (h ps://c ea i ecom-
mons.o g/licenses/by/4.0/).
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 2 o 9
Magalhães S., Gonçal es A.R., Es upiñan A.P., Ribei o D.A., dos San os B.P., Gomes A.C., A aújo L.
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision Technique in he Managemen o Ch onic Pain doi:10.5281/zenodo.17533392
quences o bo h pa ien s and socie y, leading o inc eased u ilisa ion o heal hca e e-
sou ces 6. Rega ding con en ional ea men s, pha macological he apies o en demon-
s a e limi ed e icacy and may be accompanied by signi ican ad e se e ec s 6,7.
Wi hin his con ex , YNSA may eme ge as a p omising app oach o ch onic pain
elie , cu en ly being s udied o i s clinical ou comes 8-10. This s ems om i s dual diag-
nos ic and he apeu ic app oach. The iden i ica ion o ea men poin s is pe o med
h ough palpa ion o speci ic scalp a eas (“poin s”) ha e lec he pa ien ’s condi ion, en-
abling a highly a ge ed in e en ion 11,12. S imula ion o hese poin s, ypically using ine
needles, aims o es o e he low o i al ene gy (Qi) and p omo e physiological balance,
esul ing in pain elie and unc ional imp o emen h ough he modula ion o nocicep-
i e signalling 13,14.
2. Founda ions
YNSA, in oduced by D Toshika su Yamamo o in 1973 12, is dis inguished om a-
di ional Chinese acupunc u e by i s unique and sys ema ic app oach. YNSA is based on
a de ailed soma o opic mic osys em, in which speci ic a eas o he scalp co espond o
di e en pa s o he body, o gans, and physiological unc ions (Figu e 1 and Figu e 2).
Figu e 1. Soma o opic maps o YNSA. (A) Rep esen a ion o he basic poin s (e.g. A, B, C),
associa ed wi h he locomo o sys em. (B) Rep esen a ion o he senso y and ce eb al poin s, ela ed
o he senso y o gans and neu ological unc ions.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 3 o 9
Magalhães S., Gonçal es A.R., Es upiñan A.P., Ribei o D.A., dos San os B.P., Gomes A.C., A aújo L.
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision Technique in he Managemen o Ch onic Pain doi:10.5281/zenodo.17533392
Figu e 2. Rep esen a ion o he “Y” poin s – s ong Yin a ea.
In con as o adi ional Chinese acupunc u e (TCA), YNSA places pa icula em-
phasis on diagnosis h ough palpa ion. The p ac i ione palpa es speci ic c anial egions
o iden i y eac i e poin s, which indica e dys unc ion o pain in co esponding a eas o
he body. YNSA poin s a e classi ied as basic poin s (e.g. A, B, C, D, E) and senso y poin s,
each wi h speci ic he apeu ic indica ions 11,15. The selec ion o poin s o ea men is
guided by he pa ien ’s esponse o palpa ion, gi ing YNSA a indi idualised and p ecise
cha ac e .
Table 1. Main cha ac e is ics o YNSA s. TCA
YNSA
TCA
O igin
Japan, 1973 (D . Toshika su Yamamo o)
China (ancien , millennia-old adi ion)
A ea o Applica ion
Exclusi ely on he scalp (mic osys em)
En i e body (mac osys em)
Diagnos ic Me hod
Palpa ion o he neck and abdomen
Pulse diagnosis, ongue obse a ion, palpa-
ion, and pa ien in e iew
Poin Sys em
Soma o opic poin s (body-mapping sys em)
Fixed poin s along ene ge ic me idians
Needle Dep h
Supe icial, subde mal inse ion
Va iable, anging om supe icial o deep
Main Indica ions
Pain and neu ological condi ions (e.g. s oke)
B oad ange o condi ions (in e nal, pain-
ela ed, e c.)
E ec
O en apid, some imes immedia e
G adual o immedia e, depending on he
condi ion and echnique
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 4 o 9
Magalhães S., Gonçal es A.R., Es upiñan A.P., Ribei o D.A., dos San os B.P., Gomes A.C., A aújo L.
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision Technique in he Managemen o Ch onic Pain doi:10.5281/zenodo.17533392
3. P oposed Mechanisms
Al hough he p ecise physiological mechanisms o YNSA emain unde in es iga-
ion, cu en e idence sugges s a mul i ace ed mode o ac ion. S imula ion o scalp poin s
appea s o engage soma osenso y a e en s a he scalp/meningeal in e ace, which may
in u n in luence neu onal ac i i y and modula e ce eb al blood low in b ain egions in-
ol ed in pain pe cep ion and mo o con ol 16,17. In pa allel, YNSA appea s o engage
descending pain-inhibi o y sys ems, po en ially ia endogenous opioids (endo phins, dy-
no phins) and monoamine (se o onin, no ad enaline) pa hways 18,19. Collec i ely hese e -
ec s may esul in a enua ion o nocicep i e signalling and unc ional imp o emen .
Addi ionally, epea ed s imula ion may induce neu oplas ic changes in he b ain, e-
o ganising neu al ne wo ks and imp o ing unc ion in pa ien s wi h neu ological condi-
ions such as s oke 20,21. An eme ging hypo hesis p oposes ha he ascia, a con inuous
ne wo k o connec i e issue, ac s as a conduc o o acupunc u e e ec s 22. S imula ion o
YNSA poin s may in e ac wi h his ne wo k, al e ing i s iscoelas ic p ope ies and cel-
lula signalling, which in u n may modula e pain pe cep ion and p omo e healing.
4. Clinical E idence
The e ec i eness o YNSA in he managemen o ch onic pain has been inc easingly
suppo ed by clinical esea ch ac oss a a ie y o condi ions. Se e al s udies ha e high-
ligh ed i s analgesic po en ial and unc ional bene i s, sugges ing ha YNSA may ep e-
sen a aluable adjunc o con en ional pain he apies.
A pilo s udy by Allam e al. 23 in es iga ed he applica ion o YNSA in pa ien s wi h
degene a i e os eoa h i is, demons a ing a signi ican educ ion in pain ollowing a sin-
gle ea men session. Pa icipan s epo ed ma ked imp o emen s in subjec i e pain
sco es, wi h e ec s no ed immedia ely a e in e en ion and pe sis ing o se e al days
pos - ea men . These indings p o ide p elimina y e idence o YNSA’s apid analgesic
po en ial in musculoskele al condi ions, pa icula ly in os eoa h i ic popula ions.
In pa ien s wi h ch onic low back pain, Camilo i e al. 9 conduc ed a clinical s udy
e alua ing YNSA’s e icacy and epo ed a subs an ial dec ease in pain in ensi y, along-
side imp o emen s in unc ional ou comes and pa ien - epo ed quali y o li e. The s udy
unde sco ed YNSA’s capaci y o a ge speci ic soma ic egions co esponding o pain ul
a eas, suppo ing he echnique’s unde lying p ecision and indi idualized diagnos ic ap-
p oach.
The applica ion o YNSA has also been explo ed in he ea men o headaches and
mig aines. Rez ani e al. 24 compa ed YNSA wi h adi ional acupunc u e app oaches and
ound compa able educ ions in headache equency, du a ion, and se e i y. Impo an ly,
pa ien s ecei ing YNSA epo ed enhanced ole abili y and sa is ac ion, sugges ing ha
he echnique may p o ide a clinically meaning ul al e na i e o pa ien s who expe ience
subop imal ou comes wi h con en ional acupunc u e p o ocols.
Fu he e idence comes om Co eia e al. 25, who success ully employed YNSA in
managing ch onic myo ascial pain in he head and neck egion. The s udy highligh ed no
only educ ions in pain in ensi y bu also imp o emen s in muscula ension and o e all
quali y o li e, ein o cing he no ion ha YNSA can exe bo h local and sys emic analge-
sic e ec s.
Mo e ecen ly, Du a e al. 26 e alua ed he use o YNSA among nu sing s uden s ex-
pe iencing ch onic musculoskele al discom o . Thei indings demons a ed a signi ican
educ ion in pain sco es and a measu able enhancemen in unc ional ou comes, including
daily ac i i y pe o mance and o e all wellbeing. These esul s sugges ha YNSA may
be bene icial in popula ions wi h epe i i e s ain o occupa ional musculoskele al pain.
Beyond pain managemen , YNSA has also shown p omising e ec s in pos -s oke
ehabili a ion. Clinical obse a ions and pilo s udies indica e imp o emen s in mo o
unc ion, mobili y, and quali y o li e, highligh ing he po en ial ole o YNSA in acili a -
ing neu oplas ici y and unc ional eco e y a e neu ological inju y 21.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 5 o 9
Magalhães S., Gonçal es A.R., Es upiñan A.P., Ribei o D.A., dos San os B.P., Gomes A.C., A aújo L.
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision Technique in he Managemen o Ch onic Pain doi:10.5281/zenodo.17533392
Howe e , mo e clinical s udies ha e ecen ly p o ided compelling e idence o he
e icacy o YNSA in ea ing a ious ch onic pain condi ions. Fo example, a 2024 ob-
se e -blind andomized c osso e ial by Kaneko e al. 27 in es iga ed he applica ion o
YNSA in heal hy pa icipan s expe iencing neck pain and shoulde s i ness. The s udy
demons a ed signi ican imp o emen s in pain educ ion and inc eased ange o mo ion,
sugges ing ha YNSA can e ec i ely add ess musculoskele al discom o h ough a -
ge ed scalp acupunc u e.
In he ealm o ch onic low back pain, a 2025 s udy by Gao e al. 28 compa ed he
e icacy o acupunc u e, including YNSA, wi h adi ional ea men s. The esul s indi-
ca ed ha acupunc u e, pa icula ly when combined wi h complemen a y he apies, sig-
ni ican ly alle ia ed pain and imp o ed unc ional ou comes, unde sco ing he ole o
YNSA in comp ehensi e pain managemen s a egies.
Also impo an , scalp acupunc u e may p oduce imp o emen s in o e all well-being
and daily unc ioning o pa ien s, highligh ing i s holis ic bene i s 29.
5. Discussion
YNSA ep esen s an inno a i e and p ecise app oach o he managemen o ch onic
pain, dis inguished by i s soma o opic o ganisa ion and diagnos ic palpa ion-based me h-
odology. The unde lying mechanisms o i s analgesic and unc ional e ec s a e inc eas-
ingly being examined h ough eme ging neu ophysiological and biomechanical models.
Among hese, he ascia hypo hesis p o ides a pa icula ly compelling explana ion, p o-
posing ha ascia unc ions as a dynamic, signal- ansducing sys em capable o media ing
local and sys emic he apeu ic e ec s 22,30.
Fascia, a con inuous h ee-dimensional connec i e issue ne wo k, is ichly inne -
a ed and mechanically esponsi e. Needle inse ion du ing YNSA gene a es mechanical
and senso y s imula ion, ini ia ing mechano ansduc ion p ocesses ha ac i a e ib o-
blas s, nocicep o s, and in e s i ial ne e endings 31,32. This in e ac ion leads o al e a ions
in he iscoelas ic p ope ies o he ascia and igge s he local elease o bioac i e mole-
cules such as adenosine, which exe s well-documen ed an inocicep i e e ec s 33-35.
These local mechanisms may con e ge wi h cen al modula ion, in luencing nocicep i e
p ocessing a he spinal and sup aspinal le els.
The ana omical con inui y o he ascial sys em also p o ides a plausible subs a e
o he acupunc u e me idian ne wo k, suppo ing he hypo hesis ha s imula ion a one
poin can in luence dis an body egions h ough ascial, neu al, and biochemical connec-
i i y 36,37. Wi hin his amewo k, YNSA’s scalp s imula ion may ac i a e a e en pa h-
ways ha in e ac wi h cen al s uc u es esponsible o pain modula ion and senso imo-
o con ol, aligning wi h cu en neu oimaging indings ha associa e scalp acupunc u e
wi h al e ed ce eb al blood low and co ical ac i a ion pa e ns.
Despi e hese mechanis ic insigh s, he cu en e idence base emains limi ed. Mos
a ailable s udies a e small-scale and he e ogeneous in design, o en lacking igo ous an-
domisa ion o s anda dised p o ocols. Fu he mo e, p ac i ione -dependen a iabili y in
palpa ion-based diagnosis p esen s challenges o ep oducibili y and c oss-s udy com-
pa ison 11. Add essing hese me hodological limi a ions h ough well-designed, mul icen-
e andomised con olled ials will be essen ial o alida e he he apeu ic consis ency o
YNSA. Complemen a y use o unc ional neu oimaging and neu ochemical bioma ke s
could u he elucida e i s mechanisms, b idging he gap be ween clinical e icacy and
physiological e idence.
Taken oge he , hese indings highligh YNSA as a p omising ye unde explo ed
he apeu ic modali y. I s in eg a i e po en ial lies in ha monising adi ional concep s o
ene gy low wi h mode n unde s andings o neu ophysiology and connec i e issue dy-
namics. This alignmen suppo s a b oade ision o pain managemen ha encompasses
bo h soma ic and sys emic egula ion.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 6 o 9
Magalhães S., Gonçal es A.R., Es upiñan A.P., Ribei o D.A., dos San os B.P., Gomes A.C., A aújo L.
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision Technique in he Managemen o Ch onic Pain doi:10.5281/zenodo.17533392
While encou aging, hese obse a ions mus be in e p e ed wi h cau ion. The me h-
odological di e si y and limi ed sample sizes ac oss exis ing s udies es ic he gene ali-
sabili y o indings. A s uc u ed e alua ion o hese limi a ions, along wi h po en ial e-
sea ch di ec ions, is he e o e wa an ed o consolida e he clinical and scien i ic ounda-
ion o YNSA.
5.1. Limi a ions and Fu u e Pe spec i es
Despi e he encou aging he apeu ic ou comes epo ed, YNSA esea ch cu en ly
aces se e al impo an limi a ions. Many clinical s udies in ol e small sample sizes and
he e ogeneous me hodologies, which es ic he s a is ical powe and gene alisabili y o
hei indings. The absence o s anda dised ea men p o ocols, including poin selec ion,
s imula ion pa ame e s, and session equency, u he complica es c oss- ial compa ison
and me a-analy ic syn hesis. Addi ionally, as YNSA elies hea ily on palpa ion-based di-
agnos ic sensi i i y, ou comes a e signi ican ly in luenced by he p ac i ione ’s aining
and clinical expe ience 11.
To enhance me hodological obus ness, la ge-scale, mul icen e andomised con-
olled ials wi h clea ly de ined in e en ion pa ame e s a e essen ial. Inco po a ing
unc ional neu oimaging echniques, such as MRI and PET, may help cla i y he speci ic
neu al ci cui s and co ical egions modula ed by YNSA, he eby p o iding objec i e
physiological co ela es o i s clinical e ec s. Fu he mo e, a ge ed s udies explo ing he
ole o he ascial sys em could expand unde s anding o i s con ibu ion o mechano ans-
duc ion and sys emic egula ion.
Fu u e esea ch should p io i ise he s anda disa ion o diagnos ic and he apeu ic
p o ocols, along wi h he de elopmen o compe ency-based aining amewo ks o im-
p o e in e -p ac i ione eliabili y. Collec i ely, hese e o s will be c ucial o es ablish-
ing YNSA as a ep oducible, e idence-based in e en ion wi hin in eg a i e pain man-
agemen .
By add essing hese esea ch and me hodological gaps, u u e in es iga ions can consoli-
da e he scien i ic ounda ion o YNSA and de ine i s p ecise ole wi hin mul idisciplina y
app oaches o ch onic pain ea men .
6. Conclusion
YNSA cons i u es a e ined and e idence-eme ging mic osys em wi h signi ican po-
en ial in he managemen o ch onic pain. Accumula ing clinical da a suppo i s analge-
sic e icacy and a ou able sa e y p o ile. Fu he high-quali y s udies and p o ocol s and-
a disa ion a e essen ial o consolida e i s scien i ic ounda ion and acili a e i s in eg a ion
in o mul idisciplina y pain managemen amewo ks.
C edi au ho s a emen : Concep ualisa ion, S.M.; Me hodology, S.M.; Valida ion, S.M.; Fo mal
analysis, S.M.; In es iga ion, S.M., and A.R.G.; W i ing – O iginal D a , S.M., and A.R.G.; W i ing
– Re iew & Edi ing, S.M., A.R.G., A.P.E., D.A.R., B.P.S., A.C.G., and L.A.; Visualisa ion, S.M. and
A.R.G.; P ojec adminis a ion, S.M. All au ho s ha e ead and ag eed o he published e sion o
he manusc ip .
Funding: This esea ch did no ecei e any speci ic g an om unding agencies in he public,
comme cial, o no - o -p o i sec o s.
Con lic o In e es : The au ho s decla e ha he e a e no con lic s o in e es .
Ins i u ional Re iew Boa d S a emen : No applicable.
In o med Consen S a emen : No applicable.
Jou nal o Complemen a y The apies in Heal h 2025: 3(3). 7 o 9
Magalhães S., Gonçal es A.R., Es upiñan A.P., Ribei o D.A., dos San os B.P., Gomes A.C., A aújo L.
The Yamamo o New Scalp Acupunc u e (YNSA) as a P ecision Technique in he Managemen o Ch onic Pain doi:10.5281/zenodo.17533392
Da a A ailabili y S a emen : The o iginal con ibu ions p esen ed in his s udy a e included in
he a icle. Fu he inqui ies can be di ec ed o he co esponding au ho .
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