Pain like pins and needles in the middle of the chest can be considered for the following reasons: 1, it may be an acute heart disease, commonly known as angina pectoris or acute myocardial infarction, which usually has a crushing sensation in the chest in addition to pins and needles, and is accompanied by chest tightness and palpitations, or some people may also have symptoms such as pallor, cold sweat and weakness of the limbs. If the above symptoms appear, you should immediately go to the hospital to check the electrocardiogram and blood troponin to clarify the diagnosis; 2, there may be a sterile inflammation of the soft tissues of the chest or thoracic cartilage, if the pain is like pins and needles, are mainly acute pain. In addition to pain, acute inflammation will be accompanied by symptoms of redness, swelling, heat and pain such as local skin flushing and increased skin temperature. The other condition may be caused by herpes zoster, which is usually manifested as a small dotted herpes on the chest that spreads to the back in a striped pattern.