Back pain like pins and needles may be due to back muscle strain, costochondritis, herpes zoster and so on. 1. Back muscle strain: prolonged bad posture or overwork will lead to back muscle, ligament, fascia, tendon and other injuries, which can be manifested as back pain like pins and needles. 2. Costochondritis: mostly due to trauma, strain, joint inflammation, infection, tumor, etc., causing rib pain, mostly dull or stabbing pain, which can be radiated to the back, resulting in back pain like pins and needles. 3. Herpes zoster: acute infectious skin disease caused by varicella zoster virus, after the initial infection, manifested as chickenpox or occult infection, the virus latent in the posterior ganglion of spinal nerves, when the body’s immunity is low, triggering herpes zoster. Neuralgia is a characteristic feature of the disease and can manifest as tingling, burning sensation and itching in the back. Back pain like pins and needles may also have other causes, it is recommended to go to the hospital in a timely manner, improve the examination to clarify the cause of the disease, and then give targeted treatment or treatment.