I am an advocate for ortholinear boards. I have used simple 4x12 split boards (Let’s Split/Levinson) since 2017 and haven’t had any pain or other issues with my wrists.
It is pretty easy to build your own now as there are hot swap PCBs that don’t require soldering.
The worst part of having a small orthro board is staring at the hundred nice looking keycaps that have no home on your board after buying a set and putting on your base 48 keys.