Kingsbrook Rehabilitation Institute
Department of Physical Medicine & Rehabilitation
The Kingsbrook Rehabilitation Institute is a comprehensive, acute-care
program. Our Institute is one of the oldest and finest on the East Coast.
The professional staff is committed to maximizing function and quality
of life for individuals of all ages who are physically or cognitively
challenged as a result of:
- Spinal Cord Injury
- Multiple Trauma
- Neurological Disorders (e.g. Parkinson’s Disease or Multiple Sclerosis)
- Congenital Deformities
- Traumatic Brain Injury
- Complications of Burns
- Bone Fractures
- Joint Replacement
- ...and other conditions.
Persons benefit from treatment programs that are customized for the individual
and modified as progress is achieved. Fitting of artificial limbs, braces
and corsets, audiometric testing, and electromyography are just some of
the other services provided. The Department specializes in the treatment
of patients following orthopedic surgery and cardiac surgery. In addition
to physiatrists (rehabilitation doctors), the rehabilitation team includes
nurses, physical, occupational and recreation therapists, speech pathologists,
audiologists, vocational counselors, dietitians, neuropsychologists, and
social workers/case managers.
Referrals to the Rehabilitation program can be initiated by a physician,
healthcare agency nurse, social worker, discharge planner, case manager,
insurance company, or by patients or family members. Treatment is offered
in both inpatient and outpatient settings. A
residency training program in Rehabilitation Medicine ensures an outstanding level of professionalism
in the service’s rehabilitation doctors.
For more information, please call 718-604-5341. Or contact the
National Rehabilitation Awareness Foundation for general information about rehabilitation.
View Kingsbrook's TBI Brochure
Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP) at Kingsbrook
Scope of Services
The Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP) at
Kingsbrook Rehabilitation Institute offers a holistic interdisciplinary
team approach to treat the impairments, activity limitations and participation
restrictions of persons diagnosed with medical, neurologic, cardiac, vascular,
pulmonary and/or orthopedic impairments. Medical and surgical conditions
commonly treated in our program include:
- Brain injuries
- Complete and Incomplete Spinal cord injury (due to causes such as trauma,
infection or cancer) affecting all levels of the spine and conditions
associated with spinal cord injury
- Fractures of the hip
- Cancer related impairments
- Lower limb amputations
- Congestive Heart Failure and myocardial infarctions
- Chronic Obstructive Pulmonary Disease
- Medical Debility following prolonged illness
The effects of injury to the brain, spinal cord on the person served may
include speech and swallowing difficulties, bowel and bladder impairment,
weakness, difficulties with balance and ambulation, pain, memory loss,
depression and anxiety. The effects of a lower limb amputation or a long
bone fracture can include weakness, limited ambulation, impaired balance
and risk of falling.
The goal of the program is to provide the person served with individualized
treatments that will optimize and maximize function and deliver care in
a sensitive and compassionate manner by competent clinicians who advocate
for their needs.
Our staff recognizes that severe impairments due to diseases involving
the brain, nerves, spinal cord and bones can affect the person served
and their families. Our treatments are guided by their preferences and
goals. The person served is provided with resources that emphasize wellness
and an active lifestyle. Our skilled clinicians communicate and collaborate
with other healthcare providers involved in the care of the person served.
The program offers a variety of services that optimize function, promote
healthy lifestyles, provide psychological and coping skills, emphasize
participation in life roles and educate the person served and their families.
Our program offers the following services to address these impairments:
- Physiatry (doctors who specialize in physical medicine and rehabilitation)
- Physical Therapy
- Occupational Therapy
- Speech Pathology
- Rehabilitation Nursing
- Recreational Therapy
- Social work and case management
- Vocational Rehabilitation
- Pain management
- Prosthetic, Orthotic and wheelchair clinics
Persons Served are admitted to our inpatient rehabilitation facility where
they receive 3 hours of individualized therapy services per day under
the direct care of a physiatrist. There is medical coverage 24 hours per
day, 7 days per week as well as nursing care. The typical length of stay
is 10-14 days, however this may be shorter or longer depending on needs
of the person served. Persons served are commonly referred from hospitals
in Brooklyn and Manhattan. While in our program, persons served have access
to medical specialists, surgical specialists, laboratory, pharmacy and
radiologic services 24 hours per day, 7 days per week as needed.
Outcomes: Persons served in our program make functional gains and the majority of
them return back to the community following discharge. For those who cannot
return back to the community, our social work and case management staff
work closely with them to ensure a safe discharge to the most appropriate setting.
Admission Criteria: Persons served must meet the following criteria to enter the program:
- Medically Stable to tolerate 3 hours of therapy per day
- Motivated to participate in the program
- In need of rehabilitation nursing services
- In need of close medical monitoring by a physician while undergoing the program
- Have goals that can be met through an inpatient rehabilitation program
Discharge Criteria: Persons served are discharged if they meet one or more of the following criteria
- Have reached the goals set by the person served and treating staff members
- Person served cannot tolerate 3 hours of therapy services per day
- Person served lacks the motivation to participate in the program
- Person served does not require close medical monitoring by a physician.
- Person served does not require rehabilitation nursing services.
- A significant change in the medical condition of the person served that
limits the ability to tolerate the rehabilitation program
Contact Information: 718-604-5341
Location: Kingsbrook Jewish Medical Center 585 Schenectady Avenue Brooklyn NY 11203
About Pain Management and Integrative Medicine at KJMC
Kingsbrook Jewish Medical Center Pain Management practice is part of a
well known and one of the oldest Rehabilitation Institutions in the US.
Patients suffering from acute and chronic painful conditions can take
advantage of a comprehensive approach to treating pain, from a conservative
to a more advanced interventional approach including injections or spinal
cord stimulators. With Physical/ Occupational Therapy Services and Neuropsychology
and Vocational specialists on site, as well as available Acupuncture and
Yoga specialists by referral, our pain management practitioners can treat
a wide variety of conditions, including neck and back pain, cancer pain,
joint pain and pain resulting from injuries. While being aware that pain
may not always be cured despite the best available treatment, the ultimate
goal of our Pain Management practice is to work together with the patient
to tailor an effective treatment plan to manage pain, restore function
and improve quality of life.
Pain Conditions We Treat
Kingsbrook Jewish Medical Center Pain Management and Integrative Medicine
specialists are trained and skilled to treat a wide spectrum of pain conditions,
including the following:
Head and Neck Pain
Cervical Myelopathy. Spinal cord damage that may result in neck, shoulder and arm pain, sensory
disturbance and weakness.
Cervicogenic & occipital headache. Headache that usually starts in the back of the neck.
Migraine Headache. Daily headache, sometimes accompanied by light and sound sensitivity.
Tension Headache. Constant headache and pressure, especially after a long day of work, linked
to stress and neck muscle tension.
Torticollis. Neck muscle contraction causing the head to turn to one side, resulting
in pain and stiffness.
Trigeminal Neuralgia. Severe, episodic, shock-like pain in one side of the face.
Degenerative Disc Disease. Deterioration of the discs of the spine, resulting in pain in the neck,
back, buttocks or thighs.
Herniated Disc. Bulging of a disc of the spine that can cause pain and numbness in the
neck, back or extremities.
Myofascial Pain Syndrome. Pain that originates in the soft tissues of the body such as muscles and fasciae.
Post Laminectomy Syndrome (Failed Back Syndrome). Pain that may persist or occur after spine surgery
Sacroiliac Joint Pain. Pain in the lower back and buttocks caused by a derangement of the joints
between the spine and the pelvic bones.
Spinal Stenosis. Narrowing of the spinal canal that results in pain or weakness in the lower
back or legs.
& Vertebral Fracture. Fracture of a vertebra in the lower back, causing localized pain in the spine.
Spondylolisthesis. Displacement of a vertebra that can cause nerve impingement with pain,
numbness or weakness in a certain body part.
Shoulder, Arm, Elbow and Hand Pain
Calcific Tendonitis of the Shoulder. Calcium deposits in the tendons of the shoulder, causing painful inflammation
Carpal Tunnel Syndrome. Compression of a nerve in the wrist, resulting in tingling sensation, numbness
or pain in the hand
Frozen Shoulder. Tightening of the shoulder joint resulting in shoulder pain and stiffness.
Golfer's Elbow (Medial Epicondylitis). Pain over the inner elbow caused by overuse injuries
Shoulder Impingement. Narrowing of the space between the bony structures of the shoulder that
leads to painful inflammation of the tendons and bursae.
Shoulder Sprain. Stretching or partial tearing of the ligaments that stabilize the shoulder,
which can cause pain and limitation in the shoulder motion.
Shoulder Tendinopathy/ Rotator cuff tear. Damage to the tendons of the shoulder causing pain, swelling and weakness
of the shoulder.
Tennis Elbow (Lateral Epicondylitis). Pain over the outer elbow caused by overuse injuries.
Wrist Sprain. Stretching or partial tearing of the ligaments that stabilize the wrist,
resulting in pain, swelling and limiting motion
Leg and Foot Pain
Ankle Sprain. Stretching or tearing of the ligaments supporting the ankle, resulting
in pain, swelling and limiting motion
Knee Arthritis. Knee pain worse during or after walking, exercise or movement, changes
Patellofemoral Pain Syndrome. Pain around the kneecap that is worse with standing, walking or climbing
stairs especially after a period of rest.
Sciatica (Lumbar radiculopathy). An irritation of the nerves which leave the spine and go down the back
of the thigh, causing shooting pain and numbness in one leg.
Chest and Abdominal Pain
Costochondritis. Pain felt in the chest wall, worse with taking deep breaths in.
Pelvic Pain. Chronic pain in the lower abdomen, originating from the intestines, bladder,
or reproductive organs
Post Mastectomy or Thoracotomy Pain. Sharp, shooting, stabbing, or burning pain in the chest or ribs after
breast surgery or thoracic surgery.
Post Hernia Repair Pain. Pain in the lower abdomen after hernia repair.
General Body Pains
Cancer Pain. Pain caused by a compressing tumor, or as a result of chemo- or radiation therapy.
Complex Regional Pain Syndrome. Pain, swelling and discoloration in one or more extremities, linked to
a disturbance of the nerves and blood vessels within that extremity.
Diabetic Neuropathy. Pins and needles or burning sensation and numbness in the hands and feet
due to nerve damage caused by diabetes.
Muscle Strain. Stretching and partial tear of a muscle or tendon resulting in pain, swelling
Phantom Pain. Pain that is perceived in a limb that has already been amputated.
Pain Management Services and Treatments
Kingsbrook Jewish Medical Center Pain Management and Integrative Medicine
practice offers a wide range of diagnostic services and traditional and
complementary therapies which include the following:
- Electrodiagnostic Studies
An electrodiagnostic study is usually a two-step study which includes:
- A Nerve Conduction Study (NCS) - a test which uses small electrical shocks
to a particular nerve and recorded by an electrode attached to the skin.
It helps the physician to determine the health state of the nerve.
- An Electromyography (EMG) - a test which uses a small needle that is inserted
in the muscle to measure and record its electrical activity. It helps
the physician to evaluate the condition of muscles, nerves and the connection
between the nerves and muscles.
- This test can be very helpful in identifying the source of the pain, whether
being an injury closer to the spine, or more to the periphery.
Rehabilitation and Integrative Medicine
- Our approach to treating pain begins with using a wide variety of conservative
and complementary treatment options — including physical and occupational
therapy, modalities such as heat, cold, ultrasound and transcutaneous
electrical stimulation, as well as referrals to acupuncture, gua sha,
yoga, tai chi or hypnotherapy — before considering medications,
injections or other surgical interventions.
Acupuncture is based on the belief that pain conditions occur when the
body's “chi” is out of balance, and involves inserting
very thin needles into specific points of the body - along “energetic
meridians” - to restore the normal balance. Full therapeutic effects
are usually seen after five - six treatment sessions.
Gua Sha (Scraping)
Gua sha is a traditional eastern method to restore balance and decrease
pain by lubricating the skin, then using a smooth edge to apply repeated
pressure in a scraping motion along the body, following certain pathways.
The full effects are usually seen after three - five sessions.
Heat modalities (moist hot packs, paraffin, fluidotherapy, hydrotherapy,
therapeutic ultrasound, etc), cold modalities (cold packs, ice massage,
vapocoolant sprays, contrast baths, etc), electrotherapy (transcutaneous
electrical nerve stimulation or neuromuscular electrical stimulation),
massage are some of the treatment modalities offered by our certified
therapists, to alleviate pain.
Physical and Occupational Therapy
Our experienced therapists on site, work with the patient one to one to
improve strength, balance, coordination, range of motion, gait, or stair
navigation, and help identify effective ways to perform activities of
daily living in the setting of the patient’s physical limitations
Weak muscles and stiff joints usually caused by a lack of activity, can
lead to pain and impaired balance and coordination. Yoga is an excellent
practice for mobilizing joints and strengthening muscles. Our collaborative
certified yoga trainers can tailor a specific yoga program (such as Hatha
and Vinyasa), based on the patient’s needs.
- Interventional Pain Procedures Under Ultrasound or X-Ray Guidance
There are a myriad of interventional procedures used to treat pain conditions.
Many of these techniques are performed under Ultrasound or X-Ray guidance,
which helps the physician deliver the therapy to the exact source of the pain.
Our Pain Management and Integrative Medicine practice is pleased to provide
a range of interventional treatments, including the following.
Epidural Steroid Injections
An Epidural Steroid Injection is a minimally invasive procedure performed
under live X-Ray guidance that is used to treat pain in the neck, shoulders,
arms, upper and lower back, buttocks, and legs. A variety of conditions
such as herniated disc, degenerative disc disease and arthritis can cause
a narrowing of the openings through which nerves exit the spine, which
results in irritation of the nerves. By injecting low doses of corticosteroids
(potent anti-inflammatory pain medications) directly to the source of
the pain (instead of much larger oral or intravenous doses) this inflammation
can be decreased, providing pain relief.
These procedures take a few minutes to perform and may be done under either
local anesthesia or comfortable sedation.
Medial Branch Blocks / Facet Joint Injections
Medial Branch Blocks and Facet Joint Injections are minimally invasive
procedures performed via X-Ray guidance used to diagnose and treat pain
from the small joints of the spine (facet joints). When these joints are
affected by acute injuries or by chronic conditions such as arthritis,
one can experience pain in the neck, upper and lower back or buttocks.
By injecting low doses of long-lasting corticosteroids and local anesthetics
directly to the source of the pain the discomfort may be alleviated.
These procedures take a few minutes to perform and may be done either under
local anesthesia or comfortable sedation.
Radiofrequency Nerve Ablations
Radiofrequency Nerve Ablation is a minimally invasive procedure performed
via X-Ray guidance to treat back and neck pain using controlled heat to
temporarily disable nerves responsible for pain. The procedure involves
inserting a specialized needle with a heated tip near the problematic
nerve, where the heat interrupts the nerve's ability to send pain signals.
Joint Injections (Shoulder, Hip, Knee)
Joint injections are minimally invasive procedures performed either via
X-Ray or Ultrasound guidance to treat pain from a variety of causes, including
osteoarthritis. Medications such as corticosteroids, local anesthetics,
or hyaluronan (i.e. Synvisc, Hyalgan, etc.) are injected directly into
the joint to provide pain relief.
This office-based procedure takes about 10 minutes to perform.
Occipital Nerve Blocks
Occipital Nerve Blocks are safe, office-based procedures used to treat
various types of headaches, including migraines. Local anesthetic with
or without a small dose of corticosteroid is used in this injection, which
is administered to the back of the head near the greater and lesser occipital nerves.
- Muscle and Joint Injections Under Ultrasound Guidance
- The injection of medication into a painful muscle or joint is used to relieve
discomfort associated with a wide range of conditions, from neck pain
to tennis elbow. By using an ultrasound machine, the physician is able
to visualize in real time the exact source of pain and guide the needle
used for injection right to the target. The medication is usually a local
anesthetic or a low dose of steroid.
Spinal cord stimulation (SCS) is a reversible, state-of-the-art treatment
for alleviating chronic pain in the extremities or back, omitting the
use of major surgery or medications, which is usually reserved for patients
who have not responded to other treatments. SCS involves the implantation
of thin flexible wires under the skin, along with a small stimulator device.
The stimulator device can be programmed to deliver electrical energy that
change the unpleasant perception of pain into a benign background tingling.
SCS is typically considered after more conservative treatments—such
as injections and medications—prove ineffective. It is most often
used to treat Failed Back Surgery Syndrome (also called Post Laminectomy
Syndrome), which is a pain condition that can develop after spine surgery,
as well as Complex Regional Pain Syndrome, which occurs when the body
fails to heal properly after an injury.