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Made a big difference honestly. Used to work in an office where I sat for 8hrs a day and my back/legs would go numb after awhile. Went all in on an ergo set up during COVID. Sit-stand desk, split keyboard, vertical mouse, etc. I figure if I use them more than 40 hrs a week and they prevent some form of RSI or back-pain, it's worth it.
Also, the other half of the equation is stretching, yoga, and walking. If I have to wait 5 min for something to run, I'll do a quick stretch while waiting.
A vertical mouse really helped me at home with my wrists. I was concerned it would negatively affect gaming, and FPS specifically. While there was a bit of muscle memory retraining the first few sessions of play, it seemed to improve my performance. Bonus, I'd say, since long play sessions would usually lead to slight wrist pain before.
Where it didn't improve performance was with my wife. Or so she says!