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Aerobars?
I've never really had hand issues, I think because I spend so much time using aerobars. Going to MTB has been a rude shock. I've got an issue with one knuckle on my left hand that's been there for months. I think maybe it's from the 24hr MTB but I can't be sure. For all I know I punched a wall while fixing a bike.
But going to Di2 after using normal TT shifters in long time trials definitely made a positive difference to hand/wrist/arm fatigue.
That’s the reason I keep looking at Di2/AX I’ve got shagged hands so I’d like to see if I’ll help. After a long ride I can hardly bend the fingers on my right hand now, especially if it’s cool out. It’s not as bad on the fixed, so could be worth a try.