Possible causes of back pain like pins and needles include muscle strain, soft tissue lesions, and pleurisy. There are many reasons for back pain like pins and needles, and the common ones are as follows: 1. Thoracic and back muscle strain: due to strenuous exercise or prolonged sedentary activities may lead to thoracic and back muscle strain, resulting in small joint dislocation or joint instability, so that the nerves around the joints are stimulated. 2. Localized soft tissue lesions in the back: fasciitis, frozen shoulder may also cause pins and needles pain. 3. Pleurisy: it can be aggravated by friction between the pleura when breathing or coughing. If the pinprick pain in the back is not obvious or aggravated after resting, you should go to the hospital in time, and the doctor will determine the specific cause of the disease through relevant examinations.