Pain like pins and needles in the arm sometimes may be caused by the following reasons: 1. It may be caused by some peripheral nerve lesions. For example, during an attack of neurogenic cervical spondylosis, there may be radiating pain in the upper extremity due to the stimulation of the nerve roots, which may cause the patient to feel the pain like pins and needles. 2. This condition may be caused by vascular lesions in the upper extremity. For example, embolism, stenosis, or vascular compression in the aorta of the upper extremity may lead to a long-term lack of blood supply to the upper extremity, resulting in such symptoms. In addition, the patient’s upper extremity may be contracture due to long-term ischemia.3. This condition may also be caused by long-term pressure on the upper extremity. For example, during the patient’s sleep or sitting or standing, one of the upper limbs is under prolonged pressure, which may lead to poor blood supply. In the process of the patient’s blood vessels being open again, there may be a pain like pins and needles in the upper extremity.4. This condition may also be caused by some old injuries to the upper extremity. For example, if there is a previous blunt contusion of soft tissue in the upper limb or an old fracture, this symptom may be left behind.