For me, using wrists supports makes all the difference. I switched to an 'Ultimate Hacking Keyboard' today which has wrist supports as an option; before this I'

For me, using wrists supports makes all the difference. I switched to an 'Ultimate Hacking Keyboard' today which has wrist supports as an option; before this I've used an Ergodox for years which I used foam wrist supports with. I think the key to wrist supports is using a split keyboard, and setting it up for negative tilting (i.e., sloping away from you).