Feeling pain like pins and needles in the chest when you inhale is mainly considered to be caused by pleurisy, with severe pneumonia and tuberculosis, which can irritate the pleura causing this symptom. It is necessary to go to the hospital to take a chest X-ray, do routine blood tests and tuberculin tests to clarify the diagnosis. If it is caused by pleurisy, it needs to be treated with effective antibacterial drugs, and if it is caused by tumor, it also needs to be treated surgically. If there is emphysema, pulmonary alveoli, which can lead to pneumothorax during strenuous exercise or frequent coughing, it is also easy to cause this symptom, and closed drainage of the chest cavity is needed, and surgery is also needed if it is serious, and oral pain medication is needed if the pain is more severe.