The reason for the pain in the rectum and anus may be thrombosed external hemorrhoids, anal fissure, perianal abscess and so on. 1. thrombosed external hemorrhoids: this is mainly because of the rupture of veins, blood leakage into the subcutaneous coagulation of blood clots, usually in the acute attack, there will be pins and needles like pain. 2. Anal fissure: anal fissure refers to a condition in which the skin of the anal canal is torn, and at the onset of the rectum and anus, there will be pain like pins and needles, which may also be accompanied by blood in the stool. 3. Perianal abscess: this disease is also known as perianal abscess, mainly due to the infection of the anal crypt, and spread to the perianal rectal space. When the disease attacks, the anus will appear red and swollen, suffocation and swelling at the same time accompanied by pins and needles like pain. Rectal anal pain like pins and needles, mostly due to anal diseases, if the symptoms occur frequently, you should go to the hospital as soon as possible to check, clear diagnosis, give targeted treatment.