Neck, back, ....SHOULDERS....that's where i get the most pain when i'm wrestling with the quilt during quilting on my DSM.....I take lots of breaks - do stretching exercises....Sometimes we get in a zone and don't realize how long we've been slouching at the machine. I hear ladies say they set their ironing board up right next to their machine....mine is across the room so i have to get up and move around. Old bones !!!!!!!