Back in the day I never hooked a strap onto my ancient Buescher straight soprano. As my bones & joints have gone all haywire in recent years, I now find it necessary to strap on -- with a flange extending the horn's strap ring to widen the angle of the dangle.
And +1 for the Lagan Wrist Saver, which effectively widens your right-hand grip as if you were playing, say, an alto sax. You can use it with your regular right thumb hook or any hook you like. (Several different models of Wrist Saver are available, so contact Lagan before ordering -- together you can make sure the model you choose will be compatible with your horn & hook. He wants you to succeed.)
Despite these & other ergonomic tweaks, my venerable fish-horn can still induce hand cramps during long sessions. I've been focusing almost exclusively on alto sax lately as a result. Just the other night as I was dropping off to sleep, Sidney Bechet floated into the room & scornfully called me a duck of a pig-goat. In French, of course.