Take breaks often. Stand up, walk around every 15-20 minutes. If you can, bend slowly backwards, then forwards as far as you can go. Repeat a few times. Drink lots of water. Eat oranges, bananas, or watermelon for potassium. Take ibuprofen BEFORE sitting down at the machine. Eat tart cherries for muscle pain. Make sure chair is at the right height. Use Machinger's gloves, or Grabaroos Quilting gloves to help move the quilt around easier, which puts less strain on the upper arms and shoulders by trying to maneuver the quilt. It also helps to have a Supreme Slider on the machine. These are what help me. I very rarely have any pain in my neck, arms, or shoulders anymore.