I don't think you will regret going for a frame setup as opposed to sit down. As far as health issues with stand up quilting there are so many variables. First how physically fit are you to begin with? Do you have any other underlying health issues like fibromyalgia? Standing at a frame for long periods of time can affect different people differently. For me, I am fine while quilting but usually that evening I am sore all over and more than ready for bed at bedtime but I have fibro so it may be factoring into the equation. I pretty much experience the same fatigue and all over body aches from doing anything physical like yardwork.