I also sit slightly more than arm's length away from my monitor when I sit up straight but I do lean forward a bit. My elbow is hanging off the table, with the part of my arm just below the wrist on the edge of the table. I used to have my arm way up to where my elbow was nearly on the table and used my wrist to aim, but after some wrist pain I switched to pivoting horizontally with my arm instead of my wrist because it was the closest to how I aimed before without actually having to strain my wrist, and have not had major wrist pain since. My tablet is tilted like 15 degrees maybe, started playing like that because I used to tilt paper slightly while I wrote and so it felt natural.