I have arthritic hands also. I hand quilt using my thumb and forefinger, which is far easier and came more natural to me than trying to push the needle with the third finger. Don't use a thimble either, I use my fingernail to push the needle. Hands are very large and nothing fit the finger. After five years I have a pretty big callous on the under finger. Funny thing is I can get pretty good stitches after a warm up period, but have the damndest time trying to write! I told that to a lady at a competition who asked me to sign out the quilts I had entered and she said I wasn't the first to say that. I hand quilt with a group of ladies and each and every one of them holds the needle differently. I tried some machine quilting around Christmas--just a tablerunner-- umm not too successful at that but will try some more. Sending a quilt out to be quilted is far too expensive for me and probably I never will--unless I win the lottery :-D