I have a table I\'m doing an ORDER BY on before a LIMIT and OFFSET in order to paginate.
Adding an index on the ORDER BY column makes a massive difference to performance
I don't know anything about "counted b-tree indexes", but one thing we've done in our application to help with this is break our queries into two, possibly using a sub-query. My apologies for wasting your time if you're already doing this.
SELECT *
FROM massive_table
WHERE id IN (
SELECT id
FROM massive_table
WHERE ...
LIMIT 50
OFFSET 500000
);
The advantage here is that, while it still has to calculate the proper ordering of everything, it doesn't order the entire row--only the id column.