I really hate to see programmers/typists suffering from RSI when it is entirely preventable with the right ergonomics. Having worked on production NLP systems, I have to say I think typing will remain a more effective way of coding for many years to come ( for many reasons, but primarily because syntaxes change often and training for syntax and context is hard ). I also had RSI for many years, and finally it started to affect me playing sports and esports.
So first, I switched my mouse to my non dominant hand ( left hand for me ), as that hand already has many things to deal with. I'm also using a workstation that allows me to mount my displays at eye-level while sitting or standing. Not hunching over is ergonomics 101. Second, I switched from a standard keyboard to a split keyboard. I tried many -- Goldtouch, Kinesis Advantage2, Kinesis Freestyle -- and ultimately settled on the Ultimate Hacking Keyboard.
I could write many more paragraphs on how I customized it and why it won out, but the most important thing is that is is split and it "felt" best, once I mastered the key placements ( arrows are in different places ).
Third, I started learning VIM. Vim is really awesome but up until recently didn't have great IDE or other editor support. Now it does so there's no reason to not use it. I mostly use it for quickly jumping around files and going to line numbers.
Fourth, I'm always looking to optimize non-vim shortcuts in my editor. For example, expand-region ( now standard in VSCode ) is one of my favorite plugins.
Fifth, I'm very conscious of using my laptop for long stretches of time. Mousing on the mousepad is much more RSI inducing than using a nice gaming mouse and the UHK keyboard.
All of this to say that RSI doesn't have to be career ending. If you're doing software work and you have functioning hands and wrists you should definitely look to optimize typing before looking to speech to code. Good luck!