Recommendations for a good gaming mouse that doesn't twist the wrist too much

I currently use a Razer Deathadder, which I love, along with a Filco Majestouch Ninja keyboard, which I also love.

Since I use my PC a lot for gaming and work, I find I get a little bit of RSI (or the beginnings of Carpal Tunnel, who knows) in my wrist from time to time. It would seem this is a symptom of a pretty big flaw in how most mice are designed. When using a mouse normally, your hand is generally horizontal-ish, aligned with the desk, which in a normal sitting position means the two bones in your forearm, which drive the "roll" rotation in your wrist, are twisted instead of straight as they are in a normal rested position. Since you generally tend to leave your hand in this position all the time when using a computer with your hand on the mouse, it leads to all the wrist pain etc, especially when you are flexing your fingers regularly to press the buttons. This seems to be a pretty well known thing and there's plenty of pictures you can find on the net illustrating it. And yet most mice, whether cheap basic ones or fancy gaming ones, don't really address this.

My left hand is fine; I tend to let it rest on the edge of the keyboard when I work since the keys I use most are Alt and Ctrl. Some people swap hands and use the mouse with their left hand from time to time to keep the tension off just one wrist. I'm pretty clumsy with my left hand so I don't think I could do that. Other people like to work with a Wacom tablet and stylus to change things up. I may give this a go some time but I think I still twist my wrist a bit when holding a pen, and I'd like to solve the problem with the right mouse.

Evoluent-vertical-ergonomic-mouse_medium

There seem to be a few basic ergonomic mice out there that fix this problem by rotating the whole mouse by 90 degrees, such as the above example, but I haven't really seen any aimed at gaming, and to be honest they look a bit big and unweildly. I also have a feeling that moving an object around in that position would be less precise than a normal mouse.

So my question is, does anybody know of any gaming mice that would alleviate this problem, and not require the user to twist their wrist as much? I think something that tilted the hand about halfway as much as those ergonomic mice, say at about 45 degrees would be more suitable, but I'm open to anything I guess.

My prerequisites in a mouse are:

  • 5 buttons. This is kind of essential now days. More than 5 is also good.
  • A really good middle mouse/scroll action. I use 3D applications for my work, and they require a lot of clicking and dragging with the middle mouse button, so something that is easy to press and feels good is essential. I really like the feel of the Razer Deathadder (and aside from twisting my wrist I find it quite comfortable) in this regard, and I have found some of the Logitech classics like the G5 etc to have a really stiff and fiddly middle mouse/scroll.
  • Something that can do 1800dpi. I don't care about anything higher since that's the sensitivity I am comfortable with.
  • Good quality build. I want something built to last, and I'm happy to pay a little bit for it, within reason.
  • Obviously, something that doesn't keep the palm facing downwards and the wrist twisted when resting on the mouse. So this can be ergonomic ones designed for this purpose, or standard gaming mice that just happen to angle the hand a bit more than most.

I'm kind of interested in the Cyborg RAT - I know it has all of those adjustable panels and stuff, does anybody know if you could rig it up so the outside edge of it is lower and the inside higher, untwisting the wrist a bit? I also just spotted this one, it looks a bit unweildly but it has 5 buttons, does anybody have any experience with it?

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