It might depend on the specific problem a person has. I've never had discomfort with the actual letter keys on QWERTY, and definitely don't feel like I'm having

It might depend on the specific problem a person has. I've never had discomfort with the actual letter keys on QWERTY, and definitely don't feel like I'm having to "reach" to get them. Where, to me, "reach" implies anything that's outside the comfortable range of motion. For example, on a standard QWERTY keyboard, I find the number keys, the Y key, and the brackets to be a reach. Dvorak actually makes that situation a bit worse for me. It moves a somewhat more frequent letter, F, into the Y key's position, and it moves the brackets further away in order to put keys that I use less often in a more accessible position. But that's me. I'd guess that this sort of thing varies a lot from person to person, because we all have different hands.