When I hand quilt, I use a device that looks like a spoon (held in the left hand under the quilt. I bought it about 5 years ago and have never seen one since. My fingers are no longer torn up from hand quilting...now if I could only find something to help with sore thumb joints...ah, the thrill of aging!
I used to do all hand quilting, but I bought a Janome 1600 and a Gracie Quilt Frame a few years ago and I can do simple machine quilting fairly quickly. I look longingly at the fancy-schmancy quilting machines (computerized Gammill, etc.) I will make do with what I have...I do a little machine quilting for my friends. I work cheap for them (we are teachers, so we aren't rolling in the dough, but thankful to be working).