Sudden pins and needles pain in the toes is usually caused by local nerve endings being irritated or compressed, and is usually common in gout, arthritis, and myofascial injuries. If the patient has no other organic disease causing the pain, it is generally considered to be related to the compression of blood vessels and nerves by wearing shoes that are too tight. This kind of pain usually does not need special treatment, local massage or hot compress can help relieve the pain. If the pain persists, other inflammatory, tumor and thrombotic diseases need to be investigated.