What conditions does Dr Ravi Agrawal treat?

Dr Ravi Agrawal treats a wide range of chronic pain conditions including lower back pain, neck pain, sciatica, spinal stenosis, joint pain (hip, knee, shoulder, sacroiliac), neuropathic pain, complex regional pain syndrome (CRPS), fibromyalgia, headaches and migraines, post-surgical pain, cancer-related pain, pelvic and abdominal pain, and post-herpetic neuralgia.

What treatments does a pain medicine specialist offer?

Dr Ravi offers interventional procedures including epidural steroid injections, radiofrequency ablation, nerve blocks, joint injections, spinal cord stimulation, regenerative medicine (PRP), and comprehensive multimodal pain management combining medication, physical therapy, and psychological support.

Do I need a referral to see Dr Agrawal in Fremantle?

Yes, a referral from your General Practitioner (GP) is required to see Dr Ravi. This referral is necessary for Medicare rebates on specialist consultations in Australia. Your GP can fax or email the referral directly to Cygnet Clinic at 109 Marine Terrace, Fremantle WA 6160.

Where is Dr Ravi's pain clinic located in Perth?

Dr Ravi consults at Cygnet Clinic, 109 Marine Terrace, Fremantle WA 6160, serving the Perth metropolitan area and greater Western Australia. The clinic is in central Fremantle with parking available nearby. Phone: (08) 9467 6373.

What is radiofrequency ablation and how long does it last?

Radiofrequency ablation (RFA) is a minimally invasive procedure that uses controlled heat to temporarily disrupt pain-transmitting nerves. It is commonly used for chronic back pain, neck pain, and joint pain. Pain relief typically lasts 6 to 12 months or longer, after which the procedure can be repeated if needed.

What should I bring to my first appointment with Dr Ravi?

Please bring your GP referral, Medicare card, relevant imaging (X-rays, MRI, CT scans), a list of current medications, previous specialist reports, and private health insurance details if applicable. The initial consultation typically takes 45 to 60 minutes.

Does Cygnet Clinic offer telehealth appointments?

Yes, telehealth consultations are available for appropriate cases. A GP referral is still required for Medicare rebates. Contact the clinic at (08) 9467 6373 to discuss whether a telehealth appointment is suitable for your situation.

What are the consultation fees for Dr Ravi?

Initial consultation (MBS Item 2801): $475.00 fee, $148.35 Medicare rebate. Follow-up in-person (MBS Item 2806): $275.00 fee, $74.25 rebate. Follow-up telephone (MBS Item 92759): $275.00 fee, $43.25 rebate. Injections (MBS Item 18242): $200.00 fee, $134.00 rebate. Fees are subject to change and indexation.

Are the pain procedures covered by Medicare?

Many interventional pain procedures attract a Medicare rebate. There may be out-of-pocket costs depending on the procedure and whether it is performed in a hospital or clinic setting. Our reception team will provide a detailed cost estimate before any procedure.

What qualifications does Dr Ravi Agrawal hold?

Dr Ravi Agrawal holds MBBS (Bachelor of Medicine, Bachelor of Surgery), MD (Doctor of Medicine), FCAI (Fellow of the College of Anaesthetists of Ireland), a Diploma in Pain Management from Ireland, a Fellowship in Pain Management from Singapore, and FFPMANZCA (Fellow of the Faculty of Pain Medicine, ANZCA), which is the highest pain medicine qualification in Australia.

What is Freo Pain Doctor?

Freo Pain Doctor manages 1 data type including referral requests. Helps you organize, track, and share your work in 1 place for teams and solo users.

Radiofrequency Ablation for Chronic Back and Neck Pain: A Patient Guide

Understanding how radiofrequency ablation (RFA) works, who it helps, how long relief lasts, and what to expect at Cygnet Clinic, Fremantle.

What Is Radiofrequency Ablation?

Radiofrequency ablation (RFA), also called radiofrequency neurotomy, is a minimally invasive interventional pain procedure that uses controlled heat generated by radio waves to temporarily disrupt the ability of specific sensory nerves to transmit pain signals to the brain. It is particularly effective for pain originating from the facet joints of the spine and the sacroiliac joint.

Who Benefits from RFA?

RFA is most effective for patients whose pain is confirmed to originate from the facet joints (the small joints at the back of the spine that allow bending and twisting) or the sacroiliac joint (the joint between the sacrum and pelvis). Conditions commonly treated include:

Chronic lower back pain from lumbar facet joint arthropathy (wear-and-tear arthritis of the facet joints)
Chronic neck pain from cervical facet joint degeneration, often following whiplash injury
Sacroiliac joint pain causing lower back and buttock pain
Knee osteoarthritis (genicular nerve RFA)

The key to successful RFA is accurate diagnosis. Dr Agrawal performs diagnostic medial branch blocks (for facet joint pain) or sacroiliac joint injections first. These diagnostic blocks temporarily numb the nerves supplying the painful joint. If you experience significant pain relief (typically more than 50 per cent) after the diagnostic block, it confirms that the joint is the pain source and RFA is likely to be effective.

How RFA Works

The medial branch nerves are small sensory nerves that carry pain signals from the facet joints to the brain. They do not control movement or sensation in the legs or arms. By applying controlled heat (approximately 80 degrees Celsius) to these nerves via a specialised radiofrequency needle, their ability to transmit pain signals is temporarily disrupted.

The procedure does not destroy the joint itself and does not fix the underlying arthritis. Instead, it interrupts the pain signals, providing a window of relief during which patients can engage more effectively in physiotherapy, rehabilitation, and daily activities.

What to Expect During the Procedure

RFA is performed as a day procedure at Cygnet Clinic, Fremantle. Here is what to expect:

Before the procedure: You may be asked to stop certain medications. Fasting is usually required for 4 to 6 hours. Arrange for someone to drive you home.

During the procedure: You will lie face down on an X-ray table. Local anaesthetic is used to numb the skin. Using fluoroscopic guidance, Dr Agrawal positions a specialised radiofrequency needle next to the target nerve. A small electrical test stimulation is applied to confirm the needle is in the correct position and not near any motor nerves. Once confirmed, the radiofrequency energy is applied for approximately 90 seconds per nerve. Multiple nerves may be treated in a single session. The procedure typically takes 30 to 60 minutes.

After the procedure: You will rest in recovery for 1 to 2 hours. You may experience some soreness at the treatment sites, which usually resolves within 1 to 2 weeks. Full pain relief typically develops over 2 to 4 weeks as the treated nerves settle.

How Long Does Pain Relief Last?

Pain relief from RFA typically lasts 6 to 12 months, and sometimes longer. The nerves eventually regenerate, and pain may gradually return. When this occurs, the procedure can be repeated if it was previously effective. Some patients achieve years of ongoing relief with periodic repeat treatments.

Is RFA Right for You?

RFA is most suitable for patients who:

Have chronic back or neck pain that has not responded to conservative treatments (medication, physiotherapy, exercise)
Have had positive diagnostic nerve blocks confirming the facet or sacroiliac joint as the pain source
Are looking for a non-surgical alternative to manage their pain

If you have chronic back or neck pain, ask your GP for a referral to Dr Ravi Agrawal at Cygnet Clinic, Fremantle, to find out whether RFA could help you.