I'm a 35 years old and have been programming since I was 12* I've had hand pain for a couple of years which I can treat and manage with a combination of massage and wrist braces which I wear at night. These wrist braces never cause a problem in terms of having a comfortable night's sleep for me (or my wife!) Fact is, I tried to be a manager for two years, which was OK, but nothing as wonderful as being a programmer. Switching back was difficult because my best skill at that point was Perl (no offense to Perl programmers) and I had to re-learn OO. So I dropped C++ and learned Java, and from there, made a significant effort to learn the nuances. The Sun Certification Exams don't *really* give you much in terms of a strong resume, but reengaging my mind in more recent technologies was worth it. Even if I was not going to get the job I wanted, I was learning enough that I could make contributions my writing my own software, or contributing to open source projects.
Epilogue: I got picked up by one of the fast-moving companies everyone is watching. There are plenty of people there who are younger and wealthier than me. So what? I have a good job and I'm very happy to go to work every day. Will I be able to do this in twenty to thirty years? I sure think it's more likely than I did six months ago.
And yes, count your blessings.
*I really ought to say that I've been programming for 23 years, just to irritate some of the little kiddies. :)