I've been using a basic Trackman Marble USB for a while... pretty decent little trackball. Not always as precise as a conventional mouse but I'll take that over wrist pain any day of the week. Requires regular de-gunking of the ball bearings, and lack of a scroll wheel can be a pain in some applications (Amazon Music, I'm looking at you).
Speaking of absolutely stupid design, there is absolutely nothing ergonomic whatsoever about the placement of the scroll wheel on a mouse. Can I get one down by my thumb or something please? I swear this was being discussed online a decade ago, yet no manufacturer has done anything about this nonsense. A bunch of designs just basically copied the Evolution vertical mice, but nobody ever thought to take it further.