I had a fair share of PvP battles too but somehow never felt or got arthritis but I do get tired at certain points. I even did well with terrible net speed when arena was publicly released.
Sanctuary certainly is one hell of an affix and a game changer in PvP but it's nerfed a lot so it's not as used anymore but boy it can be annoying on many builds as I've known. Even more so in the past.
I do remember somehow a build could bypass sanctuary by a bug or accident and kill me instantly such as Blinkstrike back in 2.0 or some other build or that the fire dot and bleed was way too fast that you couldn't survive Sanctuary.
Well until sanctuary removed bleed dot and fire dot when they used to be OP. Stealth was once a big thing though and it could be annoying even in sanctuary but now stealth isn't used in PvP for obvious reasons.
Still sanctuary is just one of those things.