If I need to piece a back, unless I'm in a hurry or have some other specific reason not to, I like to throw some bands of blocks into the seams. Usually fabric from the front, but sometimes it's coordinating fabric I bought FOR the quilt but it ended up not making it INTO the quilt top for whatever reason. Sometimes I do neat blocks, sometimes I do "improvisational piecing" with wonky shapes and slices. Sometimes I do just one, sometimes I do a big "plus" sign, sometimes I make it a block off in a corner... The back is sort of my playground.
I like whole-cloth backs the best, but pieced backs can be a lot of fun.
I quilt on my DSM and rarely have problems. The only time I've had issues is when I did a double-sided, fabric-foundation pieced crazy quilt and all my block intersections lined up front & back. HUGE knots of fabric that I could barely sew through, had to just start driving around those!