All of the things you've tried are steps down the right path, but I hate to say the one thing I don't see you mention is a new KEYBOARD.
The keyboard is a tool you use every day, during those 40 hours. A poor keyboard is guaranteeing murder on your hands. I had issues for years, which were/are exacerbated by an injury I sustained when I was younger (nerves, all tendons and significant portion of artery destroyed in my left hand, which required extensive surgery).
The one change I have found, repeatedly, that has made the most significant different is a keyboard. I won't go overboard in recommending any particular setup, as I find different people have different preferences - I find the best relief in mechanical switch (I used das keyboard for years but have moved to majestouch recently as DKs have wonky controllers), but a lot of people swear by ergonomics, etc. I can't use ergonomic/split hand keyboards well because of limits on my bad hand, but YMMV.
One of the best resources I've still found is from JWZ, who talks about all the different steps he went through in his own wrist pain:
Another set of things I recommend is to make sure you use your muscles in different things than just typing. Get a stress ball and some light-weight finger exercisers (You can usually get them at guitar stores, it has a spring loaded "weight" for each finger and you can flex individually).
I am by no means a doctor, but I've dealt with a lot of re-constructive therapy on my own hand, and my own typing issues (seriously, look into a better keyboard. The $20 membrane switch piece of crap that came with your computer is NOT helping things at all). On top of it my mom was an OR nurse for ~30 years and had hand issues of her own that stemmed from the fact that apparently holding medical instruments in one position for ~12 hours a day is bad for your hands too.
Make sure you get good tools, not just augmentation (like padding) to the tools you already have. And give your stressed muscles other things to do, so you aren't just straining them in the same positions and actions day after day.
The keyboard is a tool you use every day, during those 40 hours. A poor keyboard is guaranteeing murder on your hands. I had issues for years, which were/are exacerbated by an injury I sustained when I was younger (nerves, all tendons and significant portion of artery destroyed in my left hand, which required extensive surgery).
The one change I have found, repeatedly, that has made the most significant different is a keyboard. I won't go overboard in recommending any particular setup, as I find different people have different preferences - I find the best relief in mechanical switch (I used das keyboard for years but have moved to majestouch recently as DKs have wonky controllers), but a lot of people swear by ergonomics, etc. I can't use ergonomic/split hand keyboards well because of limits on my bad hand, but YMMV.
One of the best resources I've still found is from JWZ, who talks about all the different steps he went through in his own wrist pain:
http://www.jwz.org/gruntle/wrists.html
Another set of things I recommend is to make sure you use your muscles in different things than just typing. Get a stress ball and some light-weight finger exercisers (You can usually get them at guitar stores, it has a spring loaded "weight" for each finger and you can flex individually).
I am by no means a doctor, but I've dealt with a lot of re-constructive therapy on my own hand, and my own typing issues (seriously, look into a better keyboard. The $20 membrane switch piece of crap that came with your computer is NOT helping things at all). On top of it my mom was an OR nurse for ~30 years and had hand issues of her own that stemmed from the fact that apparently holding medical instruments in one position for ~12 hours a day is bad for your hands too.
Make sure you get good tools, not just augmentation (like padding) to the tools you already have. And give your stressed muscles other things to do, so you aren't just straining them in the same positions and actions day after day.