Digital nerve blocks are an essential component of hand surgery but can cause significant discomfort during injection. Strategies to minimise this discomfort are vital to improve patient experience and post-operative outcomes. Key evidence-based techniques to achieve more tolerable digital nerve blocks are summarised below (1-3). (1) Buffering lignocaine with sodium bicarbonate neutralises acidity, reducing the burning sensation. (2) Warming the anaesthetic to body temperature minimises the discomfort of cold injections. (3) Smaller needle decreases tissue trauma during insertion. (4) Slow injection reduces pain from rapid tissue distension. (5) Distraction techniques (e.g. vibration, tactile stimulation near the injection site) reduces pain perception. (6) Adrenaline mixtures prolong anaesthesia, minimising the need for repeat injections. (7) Patient preparation through clear explanations and positioning the hand comfortably reduces anxiety and associated pain. Incorporating these simple, evidence-based techniques into practice significantly enhances patient comfort during digital nerve blocks and should be routinely considered by clinicians involved in hand surgery procedures. References: 1. Strazar AR, Leynes PG, Lalonde DH. Minimizing the pain of local anesthesia injection. Plastic and Reconstructive Surgery. 2013 Sep 1;132(3):675-84. 2. Hogan ME, Perampaladas K, Machado M, Einarson TR, Taddio A. Systematic review and meta-analysis of the effect of warming local anesthetics on injection pain. Annals of Emergency Medicine. 2011 Jul 1;58(1):86-98. 3. Scarfone RJ, Jasani M, Gracely EJ. Pain of local anesthetics: rate of administration and buffering. Annals of Emergency Medicine. 1998 Jan 1;31(1):36-40.