If this mouse didn't alleviate my slight but increasing wrist pain, I was ready to box it up and return it in just a couple of days. But during the first five minutes of using it, I knew this was my solution. You can see in my photo the natural "handshake position" it gives me: my wrist is cocked back slightly because I was moving the mouse to the right when I took the photo (oops). But the way it gets your thumb up off the desk is really what matters. It does it for me, anyway.

I kind of wish I had bought the wireless version. I do not need any more competing wireless signals in my home office, so I went with USB cable, and that's fine for my office. But I like it so much I want to take it on the road with me too, and the cord will be a hassle. Oh well. It will be worth it!

Ergonomically, this has stopped my wrist from hurting. It lifts your wrist up just enough. Very easy to get used to using. I use it without a mouse pad and it's still very responsive.

I can't speak for the extra buttons (DPI, fwd/bwd) as they don't work out of the box on a mac and I couldn't be bothered to manually map them. But they seem like they are in good spots.