I too have struggled with hand/ wrist pain while riding. My bikes seem to be set up correctly as far as fit is concerned and I am very aware of my pedaling and make sure to spin in an easy enough gear so as to not beat up my knees. For the past eight weeks I have been working out in the pool doing aqua aerobics and have noticed a significant improvement in my core strength, and now I am able to ride with virtually no pain in my hands/ wrists. YMMV though, I just kind of realized this about one week ago and had to ask my PT about it. He said, "yea, pretty cool, huh?". Who knew?