Non-Operative Spine Care · Marin County
All of Your Spine Options.
One Expert. Right Here in Northern California.
Dr. Katsuura believes in treating the whole patient first — not everyone needs surgery. Every new patient begins with an evaluation of non-operative options: physical therapy, orthobiologic treatments, activity modification, and targeted pain management, guided by a surgeon who understands exactly what conservative care can and cannot achieve.
Equally important to Dr. Katsuura is the foundation that makes all spine treatment more effective — muscle strength and bone health. Weak paraspinal muscles and poor bone density are among the most overlooked drivers of spine pain and surgical risk, and Dr. Katsuura and his Assistants work with each patient to optimize both before, during, and after any intervention. The result is a practice where surgery is the last resort — and where patients who do eventually need an operation are in the best possible condition to sail through it and recover fast.
The Science
What is Non-Operative Spine Care?
Non-operative spine care is the range of treatments that address back and neck pain without surgery — including physical therapy, targeted exercise, anti-inflammatory medications, corticosteroid injections, orthobiologic therapies like PRP, and lifestyle modifications such as weight management, bone density restoration and activity optimization. The goal is to reduce pain, restore function, and address the underlying causes of spine problems — muscle weakness, poor posture, disc degeneration, and inflammation — before ever considering an operation. For the majority of spine patients, a well-designed non-operative program is all that is needed to get back to full, active life.
How Non-Operative Spine Care Works
1. Thorough Evaluation Before any treatment begins, Dr. Katsuura takes the time to understand the full picture — your imaging, your symptoms, your lifestyle, your goals, and what you've already tried — so the plan is built around you, not a generic protocol.
2. Reduce Pain and Inflammation The first priority is getting you out of pain. Depending on your diagnosis this may include targeted injections, anti-inflammatory medications, orthobiologic therapies like PRP, or a combination — chosen specifically for your condition and anatomy.
3. Rebuild the Foundation Once pain is under control, the focus shifts to the muscle strength and bone health that protect your spine long-term. Weak core and paraspinal muscles are among the most common — and most treatable — drivers of chronic spine pain, and rebuilding them is central to lasting recovery.
4. Lifestyle Optimization Sleep, nutrition, body weight, stress, toxin exposure (such as smoking) and daily movement patterns all have a direct and measurable impact on spine health. Dr. Katsuura works with each patient to identify and address the lifestyle factors that may be slowing recovery or driving recurrence.
5. Monitor, Adjust, and Decide Non-operative care is not a set-it-and-forget-it approach. Dr. Katsuura tracks your progress closely, adjusts the plan as needed, and gives you an honest assessment at every step — including a straight conversation if and when surgery becomes the better answer.
Conditions Treated
Osteoporosis
Spine fractures
kyphosis and scoliosis
Herniated or bulging disc (lumbar or cervical)
Spinal stenosis — narrowing of the spinal canal
Foraminal stenosis — pinched nerve at the exit point of the spine
Sciatica — leg pain, numbness, or weakness from a compressed nerve root
Neck pain radiating into the arm (cervical radiculopathy)
Degenerative disc disease
Bone spurs pressing on nerves
Failed back surgery syndrome — persistent pain after a prior spine procedure
Recurrent disc herniation
Sacroiliac (SI) joint dysfunction
Facet joint arthritis causing nerve compression
Lumbar or cervical myelopathy — spinal cord compression
Why does Dr. Katsuura Believe in Non-Operative Care?
The fact that Dr. Katsuura is a surgeon is precisely what makes his non-operative recommendations so valuable. A physical therapist or pain management specialist can tell you what conservative care can do — but only a surgeon who operates on spines every week knows exactly where its limits are. Dr. Katsuura has seen firsthand what under treated spine conditions look like on the inside, which muscles have wasted, which discs have collapsed beyond recovery, and which patients wish they had acted sooner — and which ones are grateful they waited. That surgical perspective gives his non-operative care a precision and honesty that is impossible to replicate without it. When Dr. Katsuura tells you that you don't need surgery, it carries a weight that only a surgeon can deliver — because he is the one who would be doing it.
Serving Marin County
Non-Operative Spine Care close to home.
Our Marin County clinic is designed for the active lifestyle patients of the North Bay — from Mt. Tam hikers to desk workers dealing with chronic neck pain.
Why Marin County patients choose us
Bay area, Sonoma and Mendocino residents are among the most active in California — and among the most prone to overuse injuries, disc issues, and spine pain from decades of hiking, cycling, and demanding professional lives.
Dr. Katsuura built this practice specifically for patients who want to stay active, avoid massive surgery, and get back to the trails, the water, and the life they love — without relying on long-term opioids or treatments that don't heal the underlying problem.
Dr. Katsuura has advanced training in non-operative spinal procedures and have treated hundreds of California spine patients with lasting results.
Frequently Asked Questions
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The fact that Dr. Katsuura is a surgeon is precisely what makes his non-operative recommendations so valuable. A physical therapist or pain management specialist can tell you what conservative care can do — but only a surgeon who operates on spines every week knows exactly where its limits are. When Dr. Katsuura tells you that you don't need surgery, it carries a weight that only a surgeon can deliver — because he is the one who would be doing it.
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For most conditions, six to twelve weeks of structured, well-designed conservative treatment is the appropriate window — but this is not a rigid rule. Patients with significant neurological symptoms such as progressive weakness, numbness, or bowel and bladder changes may need to move faster. Dr. Katsuura monitors your progress closely and will tell you honestly when the evidence suggests it is time to reconsider your options.
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The ones with the strongest evidence are also the least glamorous — consistent core strengthening, weight management, quality sleep, smoking cessation, and reducing prolonged sitting. Individually each helps; together they can be transformative. Dr. Katsuura works with each patient to identify the specific lifestyle factors most relevant to their condition and builds a practical, realistic plan around them.
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Yes — and it is often essential. Patients who have had prior surgery frequently benefit from targeted rehabilitation, orthobiologic therapies, and lifestyle optimization to protect the levels above and below the surgical site and reduce the risk of recurrence. Dr. Katsuura has extensive experience managing post-surgical spines and designing non-operative programs that avoid surgery whenever possible.
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Pain management physicians are becoming more aggressive by performing invasive procedures on the spine without proper surgical training. Do you want a pain doctor in your spine or a fully trained and boarded spine surgeon?
Pain management also focuses primarily on controlling symptoms — using medications that reduce pain in the short term such as opioids or even surgical procedures that offer little benefits. Dr. Katsuura's non-operative approach is realistic and based on extensive experience and training with both operative and non-operative care. Dr. Katsuura addresses the underlying structural and lifestyle drivers of your condition with the goal of genuine long-term recovery. And because he is a surgeon, every recommendation is made with full knowledge of what the surgical alternative looks like — so you always know exactly where you stand and what your options are.