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4141 Fifth Street Rapid City, SD 57701
Phone (605) 341-2424 | Fax (605) 341-4547

Nonsurgical Care

Below are some nonsurgical treatment options that can work for you.

Conservative Treatments


In some instances, time may provide relief for your aches and pains. You may consider waiting several months to determine if your condition will improve on its own.


Medicine, in some cases, may lessen swelling and reduce pain, providing symptom relief. The type of medication your physician recommends depends on your symptoms and your level of pain.

If your pain symptoms are mild to moderate, your physician may suggest a non-narcotic drug, like acetaminophen. Symptoms may be relieved by nonsteroidal anti-inflammatory drugs (NSAID) such as ibuprofen products. Aspirin might also be recommended to ease pain.

If your pain symptoms are severe, a prescription non-narcotic medicine may be recommended. Muscle relaxants are also beneficial in reducing pain symptoms.

Relaxation Techniques

Relaxation can help you control pain, use your energy more effectively and reduce tension. Since relaxing is a learned response, it takes practice. Initially, you need to set aside specific times during the day to practice. Eventually, tuning into tense, tight muscles and relaxing those muscles will become automatic.

Deep Breathing

  1. While lying on your back, bend your knees and move your feet about eight inches apart. Turn your toes slightly outward.
  2. Scan your body for tension.
  3. Place one hand on your abdomen and one hand on your chest.
  4. Inhale slowly and deeply through your nose into your abdomen to push up your hand as much as feels comfortable.
  5. Your chest should move only a small amount at the same time as your abdomen.
  6. When you feel at ease with the previous step, smile slightly, inhale through your nose and exhale through your mouth to make a quiet wind-like sound. Your mouth, tongue and jaw will be relaxed. Take long, slow, deep breaths to raise and lower your abdomen. Focus on the wind-like sound and feeling of breathing as you become more relaxed.
  7. Concentrate on your abdomen's movements, the air moving in and out of your lungs, and the feeling of relaxation that comes from breathing deep.
  8. Continue deep breathing for five to 10 minutes. Do this exercise one or two times daily for a few weeks. Then, if you wish, extend the time to 20 minutes.
  9. At the end of each deep breathing session, take time to scan your body again for tension. Compare the tension you feel at the conclusion of the exercise with the tension you experienced when you began.
  10. When you become comfortable with breathing into your abdomen, practice it sitting or standing when you feel tense.

Body Awareness

  1. This technique allows you to focus on different body parts to bring about relaxation.
  2. Get into a comfortable position. Close your eyes and think of your face muscles. Let them totally relax.
  3. Then, move on to your shoulders, then arms and hands. Continue to focus on the different body parts allowing each part to relax before moving to the next part.


  1. Imagery brings you to a relaxed state through pleasant thoughts and pictures.
  2. Close your eyes and picture a pleasant scene - an ocean, meadow or special place.
  3. Next, focus on the sights, sounds and smells of the pleasant scene as you relax.


  1. Use relaxation techniques before beginning a work task and to break up activities that cause excessive fatigue.
  2. Play soothing music as you work.
  3. Think pleasant thoughts.
  4. Take short rest breaks as needed.
  5. Alternate tasks so you aren't doing one thing in one position for long time periods.

How to Practice Relaxation

Environmental factors to enhance relaxation include:

  1. Turn down the lights.
  2. Close the door.
  3. Be in a room that is comfortably warm and quiet.
  4. Wear loose, comfortable clothes.
  5. Keep interruptions to a minimum.

Epidural Injections

Epidural injections of cortisone may reduce the inflammation and/or swelling of the nerves in the epidural space resulting in decreased pain, tingling and numbness. The procedure involves inserting a needle of a long lasting steroid (cortisone) through the skin and deeper tissues into the epidural space. The epidural space is the area surrounding the spinal cord and the nerves coming out of it. One or more injections may be needed to relieve symptoms.

Physical Therapy

Black Hills Neurosurgery & Spine uses ProMotion Physical Therapy to help patients return to activity. Click here for more information about physical therapy and here to learn about our therapists.

Nonsurgical Care Facts

Did you know spine surgery is an elective procedure?

The primary goal of treatment at Black Hills Neurosurgery & Spine, formerly known as The Spine Center at Rapid City, is a return to function. Many people are misinformed and believe that spine surgery is the ONLY way to achieve this. Fact-there are twice as many spine surgeries performed in the United States compared to every other country in the world.

In some cases, however, spine surgery is the best and most appropriate method of treatment. Patients that experience emergency symptoms, such as loss of control of their bowel or bladder, or weakness in a leg or arm, should not delay surgery in order to avoid permanent paralysis.

The Neurosurgery and Spine Center has two spine-specialized surgeons who already receive the most complex cases of neurosurgery & spine surgery from across South Dakota and surrounding states. Neuro and spine-specialized surgeons are the best option when complex surgery is necessary.

The decision to undergo spine surgery should not be taken lightly. The criteria for surgery are specified by a written protocol. If a person displays red flag symptoms, like cauda equina or progressive neurological deficit, spine surgery is promptly recommended. However, spine surgery can often be delayed in order to give the patient an opportunity to recover without surgery.

Those patients who ultimately require surgery often recover more quickly and easily, thanks to conservative pre-operative care.

Why do we emphasize a non-surgical approach?

Research studies have shown that patients who undergo simple spine surgery have the same long-term outcome as those patients who pursue a non-surgical approach.

Generally speaking, you should view spine surgery as a last resort, rather than your first option. We recommend trying non-surgical approaches first, and then rely on spine surgery if necessary. One of the most common, long-term types of back pain, for example, can occur as a result of spine surgery that does not go as planned. Patients who have less-than-ideal outcomes from spine surgery are referred to as "failed back surgery" patients. Sometimes these individuals have long term pain complications either from their initial problem, or from the surgery that was intended to correct the initial problem.

What should you expect during your visit to Black Hills Neurosurgery & Spine?

During the first visit with the physician at our Neurosurgery & Spine Center, a medical history will be taken. The physician then reviews the history, and collects more specific information during the patient exam.

In the exam, the physician may move certain joints and limbs in ways that reveal diagnostic information about the back or neck problem. Be sure to answer all the physician's questions honestly because certain movements are intended to produce, or not produce, discomfort. What you feel helps the physician diagnose your problem correctly. Consequently it is crucial to answer questions accurately.

For simple muscle-related back pain, X-rays are of limited value because they don't show muscles and discs, only bones. A physician may use X-rays to determine if there are any fractured vertebrae after a fall, or if there is a narrowing of the disc space which may imply a disc problem.

In some cases, the physician may use MRI or CT to determine what may be causing the person's pain. These tests are painless and function simply as a medical photograph of your body.

Book Resources




Exercise Library neurosurgery and spine center in north dakota, wyoming and nebraska

These stretches and exercises can relieve pain symptoms, strengthen the back and neck, and increase flexibility and resistence to future strain. Learn more.

anatomy library  neurosurgery and spine center in north dakota, wyoming and nebraska

Learn what causes your back or neck pain with medical illustrations and narrated animations. Click here.


Numerous patients have shared their life-changing experiences with the physicians at Black Hills Neurosurgery & Spine. Read more.

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