You can use Dvorak and QWERTY together. I’ve been using Programmers Dvorak together with QWERTY for 10+ years. Whenever I need to use common shortcuts I switch layouts with a simple shortcut, and sometimes do this dance a few times if a few seconds subconsciously as needed. Typing speed is unimportant, it’s the reduced strain that is the main benefit.
Edit: And want to clarify from reading other comments: I was a touch typist on QWERTY, had the recommended posture, and even used ergonomic keyboards. The pain happens in your knuckles and back of your hand, not wrists. Zero of that ten years later.