I used to do the inversion for up to half an hour at a time. After that much time the shoulders could get a little sore but nothing to write home about. Definitely not as painful as the weight on the ankles with the tables. The padding is good and there's much more surface area being used with the shoulders than the ankles.
For twisting, basically you hold the legs and twist your torso around from side to side. You can also stretch your legs doing the splits also while twisting the body around.
These things have been around forever. I remember seeing a Groucho Marx TV show episode from the 50's where the inventor of this brought one on the show to demonstrate. Simple, but it works really well.