If you have good hand positioning and you aren't tensing up, you shouldn't get any problems. I've been barding super hard for four and a half months now with nary a pain in my hands. No macros, no special mouse, just tapping my 1-8 keys. You just don't want your wrist bent while your fingers are working. Your hand should be a gentle curve from wrist to fingertips, like classical pianists' hands look when they're playing.
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