Does als cause pins and needles?

Yes: Amyotrophic lateral sclerosis, or Lou Gehrig's disease is a progressive degenerative motor neuron disease. In 20-30% of the people with amyotrophic lateral sclerosis, initial onset of tingling, and paresthesia can proceed motor symptoms, without objective sensory loss on examination as part of amyotrophic lateral sclerosis-plus syndrome.

No: ALS affects the motor nerve cell, and does not primarily cause sensory problems, but if atrophy were to get advanced, superimposed nerve compression could occur with secondary pins and needles.