I typed Dvorak for 10 years before I started getting RSI again in my right ulna. It turns out that the 'S' key being hit by the pinky in Dvorak caused me a lot of pain.
I ended up switching to BEAKL, a pretty obscure layout which is specifically made to alleviate stress on the pinky. It moves the relatively common S key to the right hand pointer finger, for instance.
It turns out that the theory underpinning the dvorak layout assumes that homerow hits are strictly better than upper and lower row, but the pinky and ring finger are such weak fingers that it's often better to move the index or middle fingers up or down a row than hit a key on the home row with the pinky.