Sewing with a hoop frame

[watervole]

My wrists have been playing up a lot recently and it's become difficult to hold fabric while stitching, so I've started to use a hoop frame in a stand.

However, I'm finding it very difficult to fasten off on the back.  The stand is very good - I can flip the hoop over for easy access to the back, but the tension in the fabric makes it difficult to slide the needle under the stitches to fasten off.  It's also hard to fasten off near the edge where the frame gets in the way - I'm using a very small hoop as it's a miniature embroidery.

Does anyone have any suggestions?