Pins and needles pain under the right rib cage, which is mostly caused by trauma, costal cartilage disease, intercostal neuritis and other diseases. 1. Trauma: due to trauma causing right rib fracture or localized muscle injury, patients may experience pain like pins and needles under the right rib cage. 2. Herpes zoster: caused by herpes virus infecting the human body and stimulating the intercostal nerves, commonly seen in the early stage of herpes zoster, patients may experience pain like pins and needles under the right rib cage. 3. Rib cartilage diseases: such as costochondritis, rib tumor, rib tuberculosis and other diseases, can cause patients to have pain like pins and needles under the right rib cage. 4. Intercostal neuritis: Inflammatory reaction of intercostal nerves due to infection, strain injury and other factors, patients may experience stabbing pain in the ribs and pinpoint pain, which may be aggravated during breathing or activities. 5. Liver and gallbladder diseases: mostly seen in cholecystitis, gallbladder stones caused by visceral involvement of pain, the patient may appear right below the ribs pain like pins and needles. There may be other reasons for the pins and needles pain under the right rib cage, so it is recommended to go to the hospital in time, improve the examination to clarify the cause of the disease, and then give targeted treatment or therapy.