My final changes were, in order of effectiveness:
- Put Ctrl on Alt, next to the space bar. Use thumb to press. This saves a huge amount of pinky and wrist contorting.
- Put Alt on Win, next to the now Ctrl key. Also use thumb to press. With both of these my pinkies have way less to do.
- Put Backspace on CapsLock. Though this does use a pinky finger, it is much easier to type than the normal backspace location requiring a hand full stretch.
- Use the Dvorak layout. Much less finger travel since more is on the home row compared to Qwerty.
- In Vim, use Ctrl+C instead of Escape to leave insert mode. Though not exactly identical, Ctrl+C is almost the same as escape and especially with the above changes is much easier to type than hitting the actual escape key.
I have been typing for 15 years since and I have zero hand pain.