I used to get get horrid neck and shoulder pain when i sewed, and it was worse when i quilted...then i got a sewing machine with auto pilot(you don't have to use the foot pedal)...and it was the best thing i've ever done! i can sew for hours now with no pain at all...i am convinced that my pain came from having to use the foot pedal...no matter how ergonomically correct everything else is, it is unnatural to sit with your foot on a foot pedal, i think it threw everything else out of whack. there are a lot of brands selling machines with auto pilot now, and the push button start/stop was amazingly easy to get used to!! go to a dealer and try one for a half hour or so...you should know right away if it will make a difference...sure did for me! Donna