Trackball scroll ring causes "computeritis" ?! :-(

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.