Pain like pins and needles in the anus is usually caused by the following conditions: 1. It may be caused by hemorrhoids, which are caused by blood reflux in the rectal venous plexus and blood deposition in the rectal plexus, resulting in pathological dilatation of the rectal plexus, causing hemorrhoids. 2. It may be caused by anal fissures. Most of them are due to dry and hard stools, which tear the skin around the anus when defecating, so there will be a stinging sensation, a small amount of bleeding, etc. 3. It may be a painful sensation caused by a perianal abscess, which will have a fluctuating sensation, a painful feeling of pressure and a fever and other symptoms, requiring incision and drainage treatment. In addition, there may be anal fistula and other conditions caused when there is anal pain like pins and needles, you need to avoid spicy, stimulating food, avoid sedentary, properly strengthen physical exercise or appropriate sitz bath warm water to promote blood circulation around the anus, usually eat more fresh fruits and vegetables to promote smooth stool and avoid dry stool.