PINE RIDGE, S.D. — The 13-year-old winced and prayed as the medicine man pierced the flesh of his back with wooden skewers.

But Robert Janis remembers trying not to show his pain as he dragged the buffalo skull around the Sun Dance circle — the ropes connecting it to the skewers in his back stretched taut, the July sun sending rivulets of sweat down his face.

He had always believed in the healing power of his people’s ceremonies. So when his grandmother, who raised him, was diagnosed with cancer last year, he danced.

“I just prayed,” he said. “My grandma was sick. That’s why I Sun Danced.”

Faced with shattering rates of alcoholism and poverty, the Lakota people are increasingly turning to the old ways for strength. In the earth-based spirituality of their ancestors, they are finding the power to heal. They are also preserving the rituals their elders fought to keep through decades of government assimilation efforts.

It wasn’t always this way.

The U.S. government outlawed Native religious practices, such as the Sun Dance, in the late 19th century. That changed in 1978, when Congress passed the American Indian Freedom of Religion Act.

Charlotte Black Elk remembers going to the reservation’s lone Sun Dance in the 1960s as a young girl and seeing only a handful of dancers, mostly old men, praying in the circle. A single young boy sat at a drum under the pine branch-covered arbor, singing with a group of older men with close-cropped hair.

“Now you go to a powwow and there’s all these little kids and they’re all singing and all these men have long hair,” she said.

She estimates tribal spiritual leaders now host more than 50 Sun Dances each summer. Young and old sing at the drum and dance side by side in the blistering sun, praying for their people.

Young Lakota especially are returning to their people’s ceremonies, finding in them the strength to avoid alcohol and drugs.

“You can look at young people and you can just pick out all the ones that participate in ceremonies,” she said. “There’s a real self-assuredness.”

She credits civil rights activists of the 1960s and 1970s for teaching the Lakota that “it’s OK to wear your hair long.”

Education has also contributed, she said. Young tribal members return from college with pride and determination.

Today, the effects of that cultural renaissance can be heard on the reservation’s only radio station, KILI.

Since the station hit the air in 1983, it has incorporated Lakota language into its programming, said Station Manager Tom Casey, a burly white guy with a beard and a love for the Lakota people.

The station’s first disk jockey spoke English and Lakota, he said.

“That, to me, was historic,” he said. “KILI’s part of building a nation, and that’s what we’re doing.”

At the Anpetu Luta Otipi treatment center in Kyle, staff use the inipi, or sweat lodge, to heal clients and teach them the importance of such traditional values as courage and wisdom. The ceremony involves praying and singing in a tarp-covered dome while pouring water over heated rocks in a central pit.

The ceremony helps clients regain a sense of family and identity, said Director Terryl Blue-White Eyes.

Artist Bob Benson, whose work can be seen on billboards across the reservation, said the Lakota are securing their future by teaching children about traditional ceremonies.

He pointed to the concept of the seventh generation, the belief in a generation of Lakota that will mend the sacred hoop of their people. That hoop — a symbol of the Lakota continuation — was broken by the 1890 Massacre of Wounded Knee, he said.

This generation of Lakota children is the seventh, Benson said.

“How are they going to lead the elders into the mending of the sacred hoop if they can’t do it themselves?” he asked.

Speaking at the high school graduation last year in Pine Ridge, Oliver Red Cloud — the 86-year-old great-grandson of the famed Lakota chief — spoke in English and Lakota as he encouraged seniors to remember their ancestors.

“Never forget those chiefs,” he said, wearing a beaded eagle feather headdress and sitting in a wheelchair. “That’s why we’re here. That’s why I’m here.”

At Pine Ridge High School, education in Lakota culture, history and language is an integral part of curriculum. In fact, administrators recently built an inipi in a grove of trees behind the school.

Bryan Brewer, transition coordinator for the school, said the healing ceremony is held for students struggling with personal issues and for those wanting to learn about their people’s traditional ways. The young are increasingly choosing to take part in ceremonies, sapping many churches, he said.

Robert Janis is among the many Lakota youth who have gone back to the old ways.

After the Sun Dance last summer, doctors could find no trace of the cancer that had been killing his grandmother, he said.

For Janis, Lakota religion has the power to work miracles.

“I know it can,” he said. “I know it did.”