I have to do make sure my hands are good and warm and then do hand stretches, take frequent breaks, and change hand positions frequently. I have a tennis ball that I roll around in my hand like a massager, especially around my thumb area, or massage the sore areas with my opposite hand. I also will use rubber finger tips, they help to grip the needle and you don't have to pull as hard/or grip as hard with them on. It really is a trial and error to find out what works best for you. Keeping your wrists as straight as you can may help also...