My hand movement is minimal with Tsangan/HHKB layout and as such, I haven't had much issue with fatigue or pain even after long stretches of typing. I find that

My hand movement is minimal with Tsangan/HHKB layout and as such, I haven't had much issue with fatigue or pain even after long stretches of typing. I find that actually, keycap profile and switch weight are bigger factors. I do have an ai03 Meridian, which is a Alice-style board (which while not ergo is more in that direction), in the closet that I need to build though but have been putting it off because it requires soldering (hotswap has spoiled me).