My wife swears by the Roller Mouse: http://www.contourdesign.com/rollermouse/ http://www.contourdesign.com/rollermouse/ It sits underneath a keyboard and uses

My wife swears by the Roller Mouse: http://www.contourdesign.com/rollermouse/ http://www.contourdesign.com/rollermouse/ It sits underneath a keyboard and uses a roller that rolls up and down and slides left and right. Takes a little getting used to, but significantly reduces hand motion and strain.