I switched to a ZSA Moonlander last year. The ortholinear layout (and my poor typing hygeine) meant I needed to relearn how to type over the course of about a month. keybr.io was very useful in this regard.
I love the keyboard now though, and don't really enjoy typing on standard membrane keyboards with staggered layouts anymore. I also went from having to take frequent breaks from typing (every 30 mins) due to wrist pain, to being able to type continuously for extended periods with no discomfort.
The price is the most painful part...but a keyboard is a tool of the trade, so I don't feel too bad splurging on it.
I have slight wrist pain on the left side, which I try (tried) to address in 3 different ways. Lower keyboards (Magic Keyboard from Apple), ergo (bought and sold so many) and gym. I think gym is the most effective for me - go 6 months and I forget about pains.
The funny thing is that I buy keyboards, say the Logitech K860, find something unbearable about them, sell them and then 1 year later, consider buying them again...
I also bought a Lily58 (ready made), it was so much money and I really don't feel like taking the time to learn to type with less keys...
I used a Microsoft Sculpt Ergonomic keyboard (https://www.microsoft.com/en-us/d/microsoft-sculpt-ergonomic...) for many years and LOVED it. I comfortably type at 120+ WPM with no pains or aches. I've owned several. Sadly they are discontinued now that Microsoft exited the accessories business.
Incase is supposed to pick up their products, but who knows when... 2024 is almost over: https://www.incase.com/pages/incase-designed-by-microsoft
In the meantime, the HP 960/965 (still not sure what the difference is) has a similar feel, https://www.hp.com/us-en/shop/pdp/hp-965-ergonomic-wireless-... but is unfortunately a bit wider (meaning right hand is less ergonomically placed for mousing).
Matias, a small Canadian company, has a direct replacement for the Sculpt, but it's not quite out yet (almost): https://matias.ca/sculpted/wireless/
I've also tried various other ergo keyboards, including split and mechanical ones, but nothing was as comfortable over the years as the Sculpt. I miss it every day :( Might just have to give the Matias one a try soon.