MB·MD monogramDr. MELISSA BURMANMD
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TREATMENT PHILOSOPHY

How I Choose the Right Treatment

Why the right diagnosis — not the newest procedure — drives every recommendation I make.

5 MIN READ [confirm]FROM DR. BURMAN
“Which treatment is the best? The answer is almost always the same — it depends on the diagnosis.”

Every procedure I offer has strengths, limitations, and situations where it may — or may not — be appropriate. My goal is never to recommend a technology because it’s available. It’s to understand why your symptoms developed and recommend the plan that best fits your diagnosis, your goals, and the best available evidence.

01

Make the right diagnosis

The most important part of any plan is an accurate diagnosis — a detailed history, physical exam, movement assessment, and, when appropriate, diagnostic ultrasound or review of imaging. Pain is often only one piece of the puzzle. Understanding which tissue is involved, and why it became injured, comes before any discussion of treatment.

02

Understand the whole picture

Two patients can have the same MRI findings and need completely different plans. I weigh factors including:

Your specific diagnosis
Severity & duration of symptoms
Previous treatments
Activity level & athletic goals
Occupation & lifestyle
Medical history & imaging
Strength, mobility, movement
Recovery timeline & expectations
03

Match the treatment to the problem

Rather than “which procedure should we do?” I ask “what problem are we trying to solve?” Different tools serve different purposes:

Rehabilitation

The foundation of recovery for many conditions — progressive strengthening, mobility, movement retraining, and load management.

Shockwave (ESWT)

For selected chronic tendon conditions and plantar fasciopathy — usually alongside rehab, not instead of it.

MLS® Laser

May reduce pain and improve comfort during rehab for selected conditions — an adjunct to exercise, not a replacement.

PRP

For selected tendon, ligament, and osteoarthritis cases when the evidence and your situation support it — individualized after evaluation.

BMAC

Bone marrow aspirate concentrate, considered in selected patients after discussing evidence, alternatives, and recovery.

Other

Medications, bracing, orthotics, guided injections, aspiration, activity modification, or referral. Sometimes the best recommendation is not a procedure at all.

04

There is rarely one “magic” treatment

Patients often ask whether PRP is better than shockwave, or BMAC better than PRP. Those questions assume the treatments are interchangeable. In reality they’re different tools for different situations.

“The better question is: which treatment — or combination — best addresses my diagnosis? That’s what we work together to answer.”
05

Shared decision-making

Patients make the best decisions when they understand their diagnosis, options, evidence, and recovery. During your visit we’ll discuss:

What your diagnosis means
Why I’m recommending a treatment — or why I may not
The expected benefits and limitations
Potential risks and alternatives
What you can do to optimize your recovery
06

My philosophy

Technology is important. Procedures are important. But neither comes before making the right diagnosis. The most advanced treatment cannot overcome the wrong diagnosis or an incomplete rehab plan. My goal is not simply to perform procedures — it’s to help you understand your condition, make informed decisions, and build a plan that supports your recovery and long-term performance.

This guide is informational and not medical advice. Every recommendation depends on your diagnosis, goals, and the current evidence.