As an FYI, I had a similar issue and tried a whole lot of things, including different mechanical keyboards, with which I had a variety of successes and failures.
But ultimately what REALLY helped was going to physiotherapy and identifying muscle groups in my back that were weak, causing me to sit weird and support my arms with muscles in my shoulders that weren't designed for that. And because all of this is connected in weird ways, the pain I was feeling in my wrists originated way back in over-stressing those shoulder muscles.
After a few weeks of an exercise program designed to target those muscles, all my RSI pains aren't just reduced, which was the sum total of the results I got from different mechanical keyboards, they were GONE. Plus, I had the added benefit of naturally sitting and walking "better" and feeling better about it.
So if you've tried different mechanical keyboards with only limited degrees of success (or have a fave keyboard you don't want to have to switch from), consider an exercise program designed to improve your posture! It is literally the single biggest thing I've done in the past year to make me feel significantly better, and not just in the case of the RSI!
I have a similar story. Bought a Kinesis advantage II at the time and it provided at best some solace. Started lifting weights and all pain was completely gone within two weeks.
Not saying it will work for others but it’s at least worth trying.
PS I ended up sticking with the kinesis, now on a 360 pro. Hands down the best keyboard I’ve ever seen or used. I recommend both deadlifts and kinesis :)
Unfortunately I was probably what most people would think is a model person in terms of activity. I used a standing desk or sitting with no backrest to maintain upright posture - I exercised all the time, did yoga with my wife, competed in powerlifting, did plenty of walking/cardio, rucking etc. I played guitar regularly and had since I was like 12 and had bouldering as a hobby so finger strength didn't seem to be an issue.
I did physical therapy for months and the issue basically came down to my nerves being the issue. I was diagnosed with Cubital Tunnel Syndrome in both elbows and also a torn TFCC tear in one hand causing pressure on the ulnar nerve in my wrists when the wrist was flexed even a little or in what was called ulnar deviation (wrist extended outwards/away from your body). I was told the most likely cause was as simple as the way I slept - with my elbows bent and potentially exacerbated due to excessive heavy gripping combined with my bone structure in my elbow simply not being very kind on me.
I've since recovered from the elbow surgeries and they are evaluating wrist surgery as well, I still sometimes have issues with my fingers going numb in the wrong position - but trust me, I went to all kinds of doctors trying to figure this out since practically every hobby I had required using my hands/fingers. Unfortunately it just seems like I was unlucky. But having keyboards that allow my hands to be in more natural positions at the very least has allowed me to continue working.
Hey I have cubital tunnel and also have an ulnar deviation in my left arm. Have you tried ergos with low profile keyboards? ZSA also makes a model called the Voyager, which is the best keyboard that I’ve ever had. Might be worth checking out. Like you with the Kinesis, the Voyager has been able to keep me in the game.
I have somewhat similar experience. I had wrist pain for years, using a wrist support and topical pain gel. MRI and other tests were inconclusive, it wasn't any of the typical problems.
A physiotherapist said the problem is not the wrists but that the pain comes from higher up in the arms. I started going to the gym, and like for you, the issues are just gone now. I haven't worn the wrist support since.
I wonder if anyone who's switched to an ergonomic setup has found that it stops working as well over time. Because I have long suspected that the real problems (in many cases) come down to weak muscles. But these ergonomic setups are likely to weaken them even more over a long enough period of time given that they try to avoid all of the strain.
Programmers are far more likely to have hyper-mobility than the general population, it makes it far more difficult / impossible to maintain good posture. If they don’t strength train they’ll end up rather weak regardless. So my general recommendation is to reduce injuries by being as ergonomic as possible while also hitting the gym. I use a reclining chair because I can’t avoid slouching no matter how ergonomic the chair is and it works for me. I also take Performance Enhancing Drugs (PEDs), hgh peptides and test cypionate. If you’ve seen what happens to people like myself with severe hEDS you’d understand why. Most programmers are not as severe but tend to have some form of ‘benign’ generalized hyper mobility.
A person in good health with good form can type with reasonable (not ideal) comfort on a standard keyboard on any height table (within reason), but:
(0) Try to feel in your body what kind of static load is on your muscles and joints. Ideally you want your body parts to be in neutral relaxed positions. It's not always possible to completely avoid static load, so try to take routine breaks, change positions, etc.
(1) At all costs avoid having nontrivial wrist extension or flexion (wrists bent upward or downward) while doing repetitive finger motions. Your hands need to be coming straight out of your forearms. The tendons that flex and extend the fingers need to pass through the wrists, and a bent wrist leaves them moving in a weak and uncomfortable part of their range of motion. My understanding is that most keyboard-related RSI comes from wrist extension or flexion.
(2) You should try to get your arms to be supported as much as possible passively from the shoulders. When sitting or standing, the upper arms should be hanging loosely at your sides with back reasonably straight and head up. The keyboard needs to be close enough to the torso for this to be possible. If your elbows are not close to your body, but are forward or out to the side, try to change your position. Being in a position where the weight of the arms is supported by the arm muscles causes fatigue and encourages compromising other joint positions in uncomfortable or damaging ways to relieve the strain. While actively typing the hands do not need to be supported by any kind of surface: let the palms "float" above the keyboard. Use the palm rest for resting, not typing.
(3) For a single-piece flat keyboard, I find it is most comfortable for the plane of the keyboard to be parallel to the forearms. The appropriate front/back tilt of the keyboard is therefore dependent on the relative height of the keyboard and the torso: if the table is high relative to the chair, the keyboard needs to be tilted up at the far side; if the keyboard is on your lap, on a low under-desk keyboard tray, or on a belly-height standing desk, then the keyboard needs to be flat or even tilted down at the far side. The major reason that old typewriters had an aggressive tilt to them was because desks are historically the right height for handwriting (i.e. tall).
(4) I find it helps a lot on a one-piece keyboard to keep the wrists with little to no ulnar deviation (turn toward the outside). It also helps to try to pronate them less (i.e. leave them turned so that the pinkies are a bit below the pointer fingers, instead of rotating them all the way flat). Split ergonomic keyboards eliminate the need to make some of these compromises by allowing the hands to be separated and allowing the sides to be "tented" (so the wrists can be less pronated) and positioned/oriented to eliminate ulnar deviation.
(5) Try not to have too sharp an impact on each keystroke. Ideally use only the necessary force for each key press to register, and try to avoid slamming your fingers down hard through the bottom of the keystroke. A keyboard with better switches can help a lot here, with reliable actuation halfway through the keystroke and tactile/auditory feedback at the actuation point. Key switches that don't reliably actuate unless smashed are the worst.
But ultimately what REALLY helped was going to physiotherapy and identifying muscle groups in my back that were weak, causing me to sit weird and support my arms with muscles in my shoulders that weren't designed for that. And because all of this is connected in weird ways, the pain I was feeling in my wrists originated way back in over-stressing those shoulder muscles.
After a few weeks of an exercise program designed to target those muscles, all my RSI pains aren't just reduced, which was the sum total of the results I got from different mechanical keyboards, they were GONE. Plus, I had the added benefit of naturally sitting and walking "better" and feeling better about it.
So if you've tried different mechanical keyboards with only limited degrees of success (or have a fave keyboard you don't want to have to switch from), consider an exercise program designed to improve your posture! It is literally the single biggest thing I've done in the past year to make me feel significantly better, and not just in the case of the RSI!