I have long used a trackball rather than a mouse. It greatly helped my "computeritis" - sore hand/wrist/arm.
One of the first trackballs I used, and my longtime favorite, was the Kensington TurboBall. 4 buttons and a scroll wheel - which IIRC could also be clicked as a 5th button. But it was discontinued by Kensington, probably because it was a mechanical trackball, and had reliability problems. After many years all six (6!) of these that I had purchased failed. I have not had good luck with the used TurboBalls that can still be purchased on Amazon.
I am currently using the Kensington Expert Mouse. 4 buttons, and a scroll ring, non-clickable. Actually 2, one on either side of my keyboard. 2 more at work, 2 more at the coast, 2 more at my mother's house, and 1 in my suitcase for trips.
I guess that you can say I have liked the Expert Mouse well enough to buy 9 of them. Serious $$$s.
But: I dislike its incline - I am currently shopping for a mouse tray to give it a negative incline. Or at least foam blocks. But at least that is hackable, although even a non-tilting mouse tray costs more $$$s. I have even tried using the trackball upside down, to get the negative incline I want. Works okay, but the USN cable gets in the way.
Worse: I have come to realize that the ExpertMouse scroll ring is bad for my "computeritis". Scrolling a ring is a much more complicated movement than scrolling a wheel. It uses many more small muscles. And my hand/wrist gets sore.
I wish I had my old scroll wheel.
I have been worked on AutoHotKey scripts to scroll using the actual trackball. Works somewhat. Most existing scripts require holding a key to scroll with trackball, which hurts; but it's easy enough to make a key press and release toggle the "scroll with trackball" mode. Worse: in AutoHotKey scrolling with trackball seems to require a timer triggered polling function, wasting power. Plus other issues as I mention in an AHK forums post: problems with displays that have different display scaling, cursor flickering, etc.
I am considering buying a trackball that has a real scroll wheel.
Or possibly one of the ITAC trackballs, that has a mode button converting it into scroll mode: the ITAC Evolution 149$ 6 buttons or ITAC Professional 189$ 4 buttons. The former's 6 buttons can all be configured. No driver SW required. OS independent. But probably only scroll up/down - no scroll left/right, without more OS dependent AHK scripts.
BTW, more and more I prefer OS independent driverless devices. Programmable once, then works everywhere else. E.g. I might be able to program mirror images of the ITAC Evolution, so that my left and right thumbs always hit the same button.
I am seriously considering buying the ITAC Evolution,. But since I nearly always buy more than 1, this quickly becomes serious money. Still, hand pain preventing me from working can cause serious loss of income.