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I use the Microsoft Natural and added a pair of SmartGlove and the pain is gone.

To help both keyboard and mouse positioning, I use the Imak SmartGlove. I play games with it as well. At first, I did not feel too much of a difference, but now I feel uncomfortable if I use the keyboard and mouse without them. I think it really helps.

Sorry, this is a bit stream-of-conciousness, but it's past my bedtime...

Here's the rub. There generally isn't a quick fix. I had a similar RSI problem. I was able to find relief with a combination of the following:

Goldtouch split keyboard (cheap on ebay, and you can still type on flat keyboards in a pinch)
          http://www.goldtouch.com/
Logitech Thumb Trackball (you really don't move the thumb much with it)
          http://www.logitech.com/index.cfm/products/details /US/EN,CRID=2150,CONTENTID=5002
IMak Keyboard and Wrist Rests (I love their stuff)
          http://www.imakproducts.com/
Under desk keyboard and mouse tray (generic off ebay)
IMak Pil-o-splint
          helps you relax your hands when you sleep, often people clench their hands while the sleep
And last, I learned dvorak
    http://en.wikipedia.org/wiki/Dvorak_Simplified_Key board

Posture is also VERY important. If you slouch when you type, nothing will help.

The most important thing though was the rest my hands received by forcing myself to learn Dvorak and thus type at 5 words per minute instead of my former blazing speed.

Unfortunately, computer related injuries form over time from repeated stress. The general rule is healing time takes as long as it took to injure yourself.

Good luck.

Oh yeah, I'm not a doc, so this isn't medical advice. Go see a doc. IMHO, it's a bad idea to get surgery for this though.

I do software development for a living and a hobby (no t.v.). So I spend a lot of time on a keyboard.

I've been interested in Dvorak for awhile, and I keep a printout of the layout and hotkeys active to flip between QWERTY and Dvorak for practice. I do 100 WPM on the former (measured) and about 20-30 WPM om the latter (guesstimate). I did some typing practice with Dvorak, similar to what one does for QWERTY in typing class, but only got as far as the home row and never got around to doing the rest. I'm still a dabbler in Dvorak.

I find it's not particuarly hard to switch if you don't think about the layout too much. Just like when I type QWERTY, it works better if I think about the words and the fingers and letters take care of themselves. I find that for both Dvorak and QWERTY, if I start thinking about the keyboard layout, I confuse myself. Of course, it's much more pronounced with Dvorak.

Dvorak and vim don't mix well for me. Mentally, vim is more like another keyboard layout that I've learned, rather than atop QWERTY. I think even if I get good at Dvorak, I'll have to use QWERTY for vim. So Dvorak will be more useful for "mass" typing, like a Word document. Relearning hotkeys will also be a pain, so I'll probably always keep a really easy and fast hotkey (e.g. Ctrl-Shift-1) to toggle keyboard layouts.

Expanding into the broader RSI topic, I've done some research and experimentation in that area, too. My original wakeup call was shooting pains from my elbow to the pinkie, while just walking around far away from any computer.

Originally, I found that a split keyboard (original Microsoft) helped. Then pain started coming back (just the wrist area).

I tried out the Smart Glove (http://www.imakproducts.com/products/smart_glove. htm) and got good results from that (it also helps with using laptops, where other ergo products can't be used).

I've tried various wrist support products, and I found the best one I've used is a gel-like product that deforms from your pressure on it and stays mostly deformed when you take your hand off. (http://www.gaylainc.com/WristRst.html)

Once I had the money to, I decided that just for the chance of improvement, it was worth sinking the money into possible hoopla. So I bought a couple Kinesis Maxim keyboards (http://www.kinesis-ergo.com/max-spec.htm) and an Aeron chair (http://www.hermanmiller.com/CDA/SSA/Product/0,159 2,a10-c440-p8,00.html), as well as a keyboard tray from Kinesis (I also have a contoured Logitech mouse, if that makes a difference).

My current opinion is that the Aeron chair is good but pricey, the Maxim keyboard is excellent, and the keyboard tray is a necessity.

The Aeron chair is unusual, because you need to sit "just so" for it to feel comfortable. "Just so" happens to be good for you, so it's like continuously being encouraged to sit properly. If you're stubborn, it won't ever feel comfortable (I often still don't sit properly). The mesh fabric is quite nice for keeping your backside cool.

The Maxim keyboard is very comfortable. The adjustable split isn't a big deal, once you get what you want (they recommend a certain setting anyway). However, the keys have a short depth (discourages the habit of killing a key and having the excess force bounce back on you through your fingers) and are quite sensitive (I've tried without success to depress it gently without actually registering a keystroke). The key layout is still familiar (unlike some other keyboards which shrink the backspace, align the key columns differently, etc.). Best keyboard I've used (out of about a half dozen Microsoft and Logitech keyboards personally, as well as old cheap ones at university computer labs).

If you're keeping your palms on your desk (or wrist rest in front of your keyboard) you're asking for problems.

If you suspend your hands in the air, you've got to use muscles to do that - some combination of the shoulder girdle elevators (upper trapezius, leveator scapula) and and elbow flexors (bicepts, brachialis). So you'll get neck, shoulder, or arm pain instead of wrist pain.

The best solution I've found is the use of SmartGloves along with frequent stretching breaks. (Don't use the gloves all the time, you want to allow those muscles to work and get stretched and strengthened; but when they're tired, they need extra support.)

Also I'm not a touch typist - I move my hands around a lot, which means slower typing (only about 40 wpm) but possibly less chance of RSI since I'm varing the motion.

Yes, I only type 40 wpm, but since I don't create text or code that fast, I only feel contrained when I'm typing in text I originally hand-wrote.

maybe a good product but check out this classic backwards pic from there web site on this page

maybe a good product but check out this classic backwards pic from there web site on this page

also works well for beating other things. can anyone say repetitive motion injury?

What made the biggest difference for me, actually, was learning to mouse with my left hand (suggested by the ergo guy at my last job).

Yes! I've been doing that way for ten years, since shortly after I starting using a box with an attached rodent on a regular basis. Helps enormously.

That, a mousepad with a built-in wrist rest, a simply keyboard wrist rest, and a cheap old "Suntouch" keyboard ($5 from the Goodwill!) with just the right action. (Most new keyboards are just too damn mushy, IMHO.)

And when I'm doing a lot of typing, I'll wear a pair of SmartGloves for extra support; but I don't use them day-to-day.