do i need a mouse with a wireless keyboard

The perception of stress injury is irrelevant. And adding the actual cursor concept in order for the mouse to work is both antithetical to the iPad's design and not a trivial design change.

If you feel the need for a mouse to that degree, buy a laptop. iPad is the wrong device for you. I am somewhat susceptible to repetitive motion and posturing issues, and after two years of using an iPad haven't experienced any issues related to it. And I use it a lot. That is of course no more evidence of the issue or lack of it than the study cited in the article, but it does indicate that the solution to healthy use of the iPad doesn't fall on adding peripherals, but in care of how it is used.

Personal experience is pain in my shoulder after years of using a mouse at a computer. I feel that same pain when moving from the external keyboard to the ipad to a affect input not supported by the keyboard. Mine is a Logitech and perhaps I should have purchased one that can manipulate the insertion point via the arrow keys as was described in an earlier post. Is it wrong to desire a device that so closely approaches your lightweight-computing needs to support this? I am not an IOS programmer nor to I have any idea programatically,, how a bluetoothe peripheral could meet my need though it seems that the Apple Magic Mouse could come close to supporting all the same gestures don't you think?