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Use heat instead of ice for pain

Dr. Brent Garcia, DACM, L.Ac., LMT  •  March 15, 2024


You have probably heard that using ice for injuries is the standard of care.

Not true, at least anymore.

Dr. Gabe Mirkin, MD, explains very well why heat is more effective and preferred over ice.

He makes a clear argument why cold should not be used for injuries, even though most everyone will tell you to ice.

But what about R.I.C.E.?

Ironically, Dr. Mirkin is the author who wrote “The Sportsmedicine Book” in 1978 and recommended you should use ice!

He is the doctor who came up with R.I.C.E. — Rest, Ice, Compression, Elevation — to treat injuries. And he is someone who keeps learning and is willing to admit that he was wrong.

Dr. Mirkin’s paper “Why Ice Delays Recovery” from 2008 basically retracted R.I.C.E.

He updated his recommendation: icing actually delays the healing of injuries. The article is short and powerful. Must-read.

From his paper:

If you are injured, stop exercising immediately….Since applying ice to an injury has been shown to reduce pain, it is acceptable to cool an injured part for short periods soon after the injury occurs. You could apply the ice for up to 10 minutes, remove it for 20 minutes, and repeat the 10 minute application once or twice. There is no reason to apply ice more than six hours after you have injured yourself. (emphasis mine)

So what should I used to administer heat?

Fomentek® Therapy bags are the best product for applying heat to an affected area.

Get the small size, which comes as a 2-pack. I have found the medium and large sizes to be too cumbersome and unnecessary. I have a video on my YouTube channel on how to fill the bag effectively. 

These bags deliver a moist heat – so it penetrates more deeply than electric heating pads.

These bags naturally cool over time – so are much safer than electric heating pads.

How long and how often should I use heat?

As often as you can, for as long as you can.

The benefit of moist heat (what Fomentek® and other hot water bottles deliver) is that you do not have the same concerns as electric heating pads.

If you can do 20 minutes per day that is good.

20 minutes per session, three times per day is even better.




Use a topical analgesic often

Dr. Brent Garcia, DACM, L.Ac., LMT  •  March 8, 2024


For joint or muscle pain, a pain relief ointment or liniment should be applied to the affected area 2-4 times per day. This is an excellent way to relieve symptoms with very few side effects.

More importantly, topicals signal your brain to bring healing to the area. They remind the body to keep working to heal itself. That’s why you should continue using topicals even after the pain subsides until the area is back to 100% function and mobility.

There are solid over-the-counter topicals available – any of them can help.

The best: Evil Bone Water

That being said, I strongly recommend one particular product: “Evil Bone Water” by Saint Apothecary (

This liniment is based on a classic Chinese herbal formula used to heal fractures and broken bones. It is made with the finest quality herbs in an Everclear base, and it is manufactured in the USA.

Don’t let the name scare you

The actual name of this formula is Zheng Xie Gu Shui. The closer translation is “Rectify [or Heal] Evil Bone Water”…”evil” meaning damaged or broken, not evil per se.

Goes without saying, but I will say it anyway: this is to heal “evil” bones and tissue in the body.

Why it is the best

I love Evil Bone Water because it can be used for anything that is painful and needs to heal: muscle, tendon, ligament, skin, or bone.

It treats all sports injuries, strains, sprains, bruises, and spinal pain. You can even apply it on cuts and insect bites.

Evil Bone Water is currently sold only by licensed acupuncturists and at VA hospitals.

Ask me about it at your next treatment. And remember, this is for external use only.

Back pain? Use Static Back®

Dr. Brent Garcia, DACM, L.Ac., LMT  •  March 6, 2024


Static Back is an Egoscue® technique that is simple to use. Pete Egoscue, an anatomical physiologist, founded The Egoscue Method in 1978.

The position is great for general low back health. 

It is also referred to as the “astronaut pose” because your body is in the position astronauts used during take off.

Here’s how to do it

  1. Lie flat on your back
  2. Use an ottoman or some other prop to support your lower legs so that your hips and knees create a 90-degree angle
  3. Place your arms flat on the ground, at an angle of 45 degrees from your torso, with your palms up
  4. Keep your head flat on the ground — no pillow
  5. Stay in the position for 5 – 15 minutes



Listen to a podcast or music if you get bored easily, but stay off your phone! This should be a time to relax.


This exercise is cumulative. Don’t expect too much if you try this one time.

Attempt to do this daily. Once a day is good. Twice a day is great. Three times a day is excellent,

Five minutes each time is good. Ten minutes each time is great. Fifteen minutes each time is excellent.


(photo/video credit:

Best hack for sleep

woman sleeping


Dr. Brent Garcia, DACM, L.Ac., LMT  •  January 22, 2021  •  Last updated: March 15, 2024


Brother Strikes Again

I was turned on to mouth taping by my brother, and separately by a mentor, both of whom had been taping their mouth shut for years while sleeping.

My brother told me about James Nestor’s book “Breath.”

I am a pretty avid reader, but I still haven’t read the actual book.

However, I have listened to podcasts where Nestor has been interviewed.

The index card summary is: we are supposed to breath through our nose, not our mouth. And, many modern day health problems can be attributed to mouth breathing.

Turns out Eleven in “Stranger Things” was right.

We should breath as much as possible through our noses – like all animals on earth do.

This includes while we sleep.

Hence, mouth taping.

How To

I use blue painter’s tape. I started with a postage-sized piece on the front of my mouth at first.

I now tape my entire mouth shut, and it’s a game-changer.


Here’s what I’ve noticed after years of consistent mouth-taping:

  1. I sleep more deeply through the night
  2. I dream more and recall dreams better
  3. I, paradoxically, experience less congestion in the morning, even though I am breathing through my nose
  4. I wake up way more rested
  5. I do not wake up with a dry, sore throat

Consistently the best sleep I’ve had in years.

Do you have something that makes a huge difference for you regarding sleep?


4-7-8 Breathing Revisited

Dr. Brent Garcia, DACM, L.Ac., LMT  •  November 4, 2023  •  Last updated: March 2, 2024


A patient just told me something profound.

I had recommended 4-7-8 breathing to him a few months ago. I was not even sure he heard me, or if he had any intention of actually doing the technique.

Turns out he had.

And he next brought it up, he surprised me.

First, a review…

What is the 4-7-8 Breathing Technique?

Dr. Andrew Weil ( is an integrative medicine physician and author who is known for his advocacy of natural and holistic approaches to health and well-being.

One of his most popular breathing techniques is the 4-7-8 breathing technique, which is a simple yet effective way to reduce stress and anxiety, improve sleep quality, and promote overall relaxation.

The 4-7-8 breathing involves inhaling for a count of four, holding the breath for a count of seven, and exhaling for a count of eight.

This breathing pattern is thought to activate the parasympathetic nervous system, which is responsible for the body’s “rest and digest” response.

How to Practice the 4-7-8 Breathing Technique

  1. Find a comfortable place to sit or lie down
  2. Place the tip of your tongue on the ridge of tissue behind your upper front teeth
  3. Exhale completely through your mouth, making a whooshing sound
  4. Close your mouth and inhale quietly through your nose for a count of four
  5. Hold your breath for a count of seven
  6. Exhale completely through your mouth, making a whooshing sound for a count of eight
  7. Repeat steps 4-6 for three more cycles
  8. You can practice the 4-7-8 breathing technique at any time of day, but it is especially helpful to practice when you are feeling stressed or anxious


Which brings us back to my patient. He told me that after practicing this for a few months, he now can just do one cycle.

He notices that his body and mind has been conditioned so that he can easily fall into a relaxive state in about 19 seconds.

Just like anything else, a practice can become easier and more effective over time.

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