How do I play D3 without getting carpal tunnel?

In theory you get a good quality mouse, make sure your chair, back, and arm are all in ideal positions (seriously, this stuff is no joke; https://www.osha.gov/SLTC/etools/computerworkstations/positions.html ) . And there are exercises you should do periodically. And a wrist brace isn't the worst idea in the world.

Limit your gaming time. I know, that's not the answer you want. But it's honestly the most effective thing you can do.

In reality, well, for those of us who spend the bulk of our work and leisure time at a computer typing and clicking, you kind of just get carpal tunnel eventually.

i use a gaming mouse which has macro capabilities (logitech, razor, basically anything that comes with software to edit binds). it's "technically" bannable, but from what i've seen no one actually gets banned for that only botters and maybe THUD users get banned for sure.

anyways in terms of what i use it for, i have a force move keytoggle that spams so i don't have to hold down a key or button to force move all the time, as well as a click spam macro to pick up stuff and auto-attack whatever, a salvage macro to auto-salvage items i hover over, a right click spam to buy from kadala fast, and lastly a simple A + S or A key spam for builds that i am too lazy to hit shit off cooldown for (Epiphany on monk, Vengeance on DH, Akharat's on sader etc.) or for necro builds that require devour to be spammed 24/7.

this basically allows me to play MOST builds w/out touching any keys/clicking, just have to use my mouse to navigate and everything else spams for me, the abilities i don't spam but still use at specific times go on mousewheel or right click for convenience (such as Air Ally for monk which i only need to use when low on spirit) and i use potion on mouse3. having all the macro spam is not really helpful in GR solo push where timing keypresses is more important and require thinking, but for speedfarming mindless rifts it's perfect.

lastly i think i big factor other than your keypresses is your mouse sensitivity. a lower sense will give you more hand fatigue in a shorter period, while a higher sense may cramp your hand because you're not moving it as much while still trying to be precise. basically find a COMFORTABLE in-between sense that allows you to click stuff precisely while also being able to move freely and aim in whatever direction you want relatively fast.

Play it on Switch

For me using a keyboard + mouse tray made all the difference in the world. My mouse sits roughly at waist level now so I use it with my arm on my chair's arm rest.

It also helps that I have a gaming mouse with adjustable DPI and I've gotten used to 6400 DPI for everything. All the movement happens in a very tiny 2" X 2" area. It does take a bit of getting used to but it's worth it.

I used to feel the strain when my mouse was on my desk but not any more.

Use a lazy build and/or gaming mouse with 4 or more buttons

I use IronMind Expand Your Hand bands and a Prohands Grip Master.

I wish they would have added gamepad support for the pc version. People have asked for it and blizzard said no. I hope more people will help push for this since they said no to wow classic so it seems like they are able to change their minds.

numlock trick

Use more macros. I mean why should your mouse hand hurt from just movign the mouse around?

Move abilities from left click, right click to W and E. The less time my hand muscles in are engaged the longer it takes for the muscles to fatigue.

builds matter a ton. i specifically look for builds that require minimal keyboard spam and instead mostly work on mouse and movement.

HotA IK barb.

Leap Quake barb.

Blessed Shield Akkhan crusader.

Impale Demon Hunter,

WoL monk.

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what these all have in common is that you can choose skills/gear that means you dont have to time attacks, etc, instead you can put a few keys on autocast, then just use a couple keys for damage, movement abilities or saves.

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if you dont know about autocasting, start there. you map your 1-4 keys to also use the numpad 1-4. press and hold you want the key to autocast, then while holding it down, turn off numlock. this will keep the key "held down" which will cast anything you set. this is good for long delay abilities or things you always want to use on cooldown. (think wrath of the berserker, vengence, etc) I also use it for ablities that are more about survival than damage, like the impale FoK with the bladed armor rune for the extra armor, i just leave it on autocast to get that effect.

Be born with better genes