I'll be the exception to the rule. Recently finished an over-sized twin log cabin. Top and backing different batiks. Warm & Natural batting. Hand quilted. Didn't notice that it was any more or less difficult or painful than any other quilt that I've hand quilted. And I hand quilt all my quilts. I do use Roxanne needles - #10 or #11 - and Thread Heaven. I also use a Thimblelady thimble and push with the pad of my finger vs. the top. Not sure if that helps or not but it's what's comfortable for me.