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A reference to the sharp tingling senstation one feels when a body part hasn't been moved for a while or when it's been pressed up against something in the wrong way.
Example 1:
Referenced in the movie PCU.
A character named 'Pigman' sits on a couch in front of a TV for seemingly days without getting up. When he finally gets up, he realizes that his body is so cramped from being still that he quickly falls to the floor and shouts out:

"Pins and needles!...Pins and needles!"

Example 2:
Referenced by the rock band Blur in a song called "Song 2":

"When I feel heavy metal
And I’m pins and I’m needles
Well I lie and I’m easy..."
by ChicagoJoe February 16, 2006
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The intense, painful feeling you get all throughout your body after you shoot up a little too much heroin, that feels like thousands of pins and needles stabbing you all over, especially your head and hands, and a full body burning sensation
I did a huge dope shot and got really bad pins and needles
by notnomore November 25, 2006
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