Both Retequizzle and I use gamepads to play. It's a ton harder than mouse because even though both types of playing have access to the same amount of precision, there's a difference between how you choose your aim.
With a mouse, you have targetted aim. This means that you can place your cursor on your target and hit exactly there. It's definitely the most powerful type of aiming in SK.
With a gamepad, your aiming is directional, though. You decide the direction with the stick as opposed to just the target and it adds another step to the aiming process where you're required to coordinate not just your hands and eyes, but also coordinate your direction and target. Besides that, you don't have any on-screen indication of where you're aiming apart from your character's direction, which is a lot harder to tell than where your mouse cursor is.
While gamepads may have more options in terms of aiming, it's worth noting that it's a lot harder than arrow key aiming. When using arrows, you aren't gonna have a hard time aiming straight northeast. They're different kinds of hard, I suppose.
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