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Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Understanding Wounds Not all wounds are the same. Some wounds heal quickly with basic cleaning and dressing changes. Others become chronic, meaning they fail to heal as expected due to pressure, poor circulation, diabetes, infection, swelling, immobility, or poor nutrition. Chronic wounds commonly include pressure injuries, diabetic foot ulcers, venous leg ulcers, arterial ulcers, traumatic wounds,

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician If you are preparing for your first visit with a pain management specialist, it is normal to feel uncertain about what to expect. Many patients worry they will not be listened to, that their pain will be dismissed, or that the visit will focus only on medications instead of finding the true cause of their symptoms. At Michigan Rehab Consultant PC, our goal is to understand the full picture of your

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Sciatica, also known as lumbar radiculopathy, is usually treatable without surgery using physical therapy, medications, and targeted injections when appropriate. Sciatica is caused by irritation or compression of a nerve root, often due to disc herniation or spinal stenosis. Most patients improve with non-operative care. What This Means for You Surgery is often not necessary. Early treatment improv

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Home-based physiatry allows physicians to evaluate and treat patients in their home, improving access, functional assessment, and overall outcomes for patients with mobility or pain limitations. Home-based care aligns closely with PM&R principles, allowing physicians to evaluate patients in their real-life environment and provide more personalized treatment. What This Means for You If getting to a

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician A physiatrist should be considered for back pain lasting more than 4 to 6 weeks, especially when associated with nerve symptoms, functional decline, or poor response to initial treatment. Physiatrists specialize in non-surgical, function-focused care. Low back pain is one of the leading causes of disability worldwide. When symptoms persist, evaluation by a physician trained in Physical Medicine and

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Traditional clinic-based care is effective for many patients, but it is not always well suited for individuals with complex medical conditions or significant mobility limitations. For these patients, the primary barrier is often not motivation, but access to care. Patients who benefit most from home-based rehabilitation include those with limited mobility, chronic pain with functional decline, neur

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Chronic pain is frequently associated with reduced levels of physical activity. While rest may provide temporary relief, prolonged inactivity often leads to deconditioning, which can significantly worsen pain over time. Deconditioning refers to the loss of muscle strength, endurance, and overall physical capacity that occurs when the body is not regularly challenged through activity. It is a common

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Falls are one of the leading causes of injury, hospitalization, and loss of independence among older adults and individuals with mobility impairments. While they are often described as “accidents,” this term can be misleading and may obscure the underlying clinical reality. In most cases, falls are not random events. Rather, they are the result of multiple interacting factors that develop over time

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Physical therapy is a cornerstone of treatment for musculoskeletal and neurologic conditions. It is widely recommended for improving strength, restoring mobility, and enhancing functional independence. In many cases, it is highly effective. However, a subset of patients completes weeks or even months of therapy without experiencing meaningful or sustained improvement. When this occurs, it is import

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician When most people think about vital signs, they think of blood pressure, heart rate, respiratory rate, or oxygen saturation. These measures provide important information about physiologic stability and organ system function. However, in rehabilitation medicine, there is another measure that is equally important—particularly when assessing function, independence, and long-term outcomes: gait speed. G

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Many patients—and even some healthcare providers—are not familiar with the role of a physiatrist. Physical Medicine and Rehabilitation (PM&R) is a medical specialty focused on restoring function, reducing pain, and improving quality of life through non-surgical, evidence-based care. A physiatrist is uniquely trained to evaluate how injury, illness, or chronic conditions affect movement and daily f

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Gait speed (how fast a person walks) is one of the most powerful and underutilized measures in clinical medicine. Often referred to as the “sixth vital sign,” gait speed provides insight into mobility, fall risk, functional independence, and overall health. Whether a patient is recovering at home, attending outpatient therapy, or residing in a skilled nursing or assisted living facility, gait spee

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Introduction Chronic wounds such as pressure injuries, diabetic ulcers, and non-healing surgical wounds often require evaluation by a specialist. At Michigan Rehab Consultant, PC, we provide advanced wound care in Clinton Township and home-based services throughout Macomb, Oakland, and Wayne County. Not all wound care is the same. Many patients receive standard wound care such as dressings, topical

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Introduction Peripheral neuropathy is a common condition that can cause numbness, tingling, burning pain, weakness, and balance problems, often beginning in the feet and lower legs. At Michigan Rehab Consultant, PC, we provide comprehensive evaluation and treatment for neuropathy in Clinton Township, with home-based services available throughout Macomb, Oakland, and Wayne County for patients with m

Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician In clinical practice, many patients with chronic pain continue to struggle despite seeing multiple specialists. While pain is often the presenting complaint, the true issue for many patients is declining mobility, loss of independence, and reduced participation in daily activities. This is where Physical Medicine & Rehabilitation (PM&R;) plays a distinct and essential role. What Is a Physiatrist? A

Understanding Evidence-Based Approaches to Diagnosis and Treatment By Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Low back pain is one of the most common reasons people seek medical care. Nearly everyone experiences it at some point, and for many individuals symptoms improve with time and conservative treatment. However, when back pain persists, worsens, or begins affecting daily function, evaluation by a specialist may be appropriate. Under

By Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Knee pain is one of the most common musculoskeletal complaints among adults and a frequent reason for medical visits. For many patients, knee pain can interfere with walking, exercise, and everyday activities. Although surgery is sometimes necessary for severe joint disease or structural injury, many patients benefit from non-surgical treatments. These may include physical therapy, activity modi

An Evidence-Based, Rehabilitation-Centered Approach By Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Physician Chronic migraine is one of the most disabling neurologic conditions worldwide. Although migraine is often perceived as simply a severe headache, it is a complex neurobiological disorder involving altered pain processing, trigeminovascular activation, and changes in central nervous system sensitivity. Many patients with chronic migraine continue

By Dr. Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation In daily clinical practice, many patients with chronic pain struggle to meaningfully participate in rehabilitation due to weight-related mechanical and metabolic limitations. While GLP-1 receptor agonists are most often discussed in the context of diabetes and obesity management, they raise an important rehabilitation-focused question: Can GLP-1–based therapies indirectly improve chronic pain and mobi

By Dr. Juliet Gaisey, MD Board-Certified Physical Medicine & Rehabilitation Many people living with chronic pain are surprised to learn that inflammation does not only come from injury or arthritis—it is also influenced by lifestyle factors, including nutrition. As a physiatrist, my focus is helping patients move better, function better, and live with less pain. While injections, physical therapy, and medications are important tools, nutrition plays a meaningful supporting ro