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.

Understanding Neuropathic Pain: Causes, Symptoms, and Treatment Options

A comprehensive overview of nerve pain (neuropathic pain), what causes it, how it feels, and the evidence-based treatments available at Cygnet Clinic, Fremantle.

What Is Neuropathic Pain?

Neuropathic pain, often called nerve pain, is pain caused by damage to or dysfunction of the nervous system itself. Unlike nociceptive pain (the pain you feel from a cut, burn, or sprain, which comes from tissue damage), neuropathic pain arises from the nerves that detect and transmit pain signals. This makes it a fundamentally different type of pain that often requires different treatment approaches.

Neuropathic pain is estimated to affect approximately 7 to 10 per cent of the population and is a significant contributor to chronic pain disability.

Common Causes of Neuropathic Pain

Neuropathic pain can result from a wide range of conditions, including:

Diabetic neuropathy: High blood sugar levels over time damage peripheral nerves, most commonly in the feet and legs. This is one of the most common causes of neuropathic pain.
Post-herpetic neuralgia: Nerve pain that persists after a shingles outbreak. The varicella-zoster virus damages nerve fibres, causing pain that can last for months or years.
Sciatica and radiculopathy: Compression or inflammation of a spinal nerve root, often from a herniated disc, causing pain to radiate down the leg or arm.
Nerve injury or entrapment: Trauma, surgery, or compression (such as carpal tunnel syndrome) can damage peripheral nerves.
Complex Regional Pain Syndrome (CRPS): A complex condition causing severe, burning pain, swelling, and sensitivity in a limb, often following an injury.
Chemotherapy-induced peripheral neuropathy: Certain chemotherapy drugs can damage peripheral nerves.
Trigeminal neuralgia: Severe, shock-like facial pain caused by irritation of the trigeminal nerve.
Alcohol-related neuropathy: Long-term excessive alcohol consumption can damage nerves.
Multiple sclerosis and other central nervous system conditions.

How Does Neuropathic Pain Feel?

Neuropathic pain has distinctive characteristics that set it apart from other types of pain. Patients often describe it as:

Burning: A hot, searing sensation, often in the feet or hands
Shooting or electric shock-like: Sudden, sharp, lancinating pains
Tingling or pins and needles (paraesthesia)
Numbness: A loss of sensation in the affected area
Allodynia: Pain from stimuli that should not be painful, such as light touch or clothing against the skin
Hyperalgesia: An exaggerated pain response to a normally painful stimulus

If you experience any of these symptoms, it is important to discuss them with your GP, who can assess whether a referral to a pain specialist is appropriate.

How Is Neuropathic Pain Diagnosed?

Diagnosis begins with a thorough clinical history and neurological examination. Dr Agrawal will assess the location, quality, and triggers of your pain, perform a physical and neurological examination, and review any relevant investigations such as nerve conduction studies, MRI scans, or blood tests. Identifying the underlying cause is essential, as this guides the treatment approach.

Treatment Options for Neuropathic Pain

Neuropathic pain often requires a multimodal approach, as it tends not to respond as well to standard painkillers (such as paracetamol or ibuprofen) as nociceptive pain does. Treatment options include:

Medication

Neuromodulatory medications: Certain medications originally developed for epilepsy or depression are highly effective for neuropathic pain. These include gabapentin, pregabalin, duloxetine, and amitriptyline. They work by modulating how nerves transmit pain signals.
Topical treatments: Lidocaine patches, capsaicin cream, or compounded topical preparations can be effective for localised nerve pain.
Opioids: Generally used cautiously and as a last resort, as neuropathic pain often responds poorly and the risks of long-term opioid use are significant.

Interventional Procedures

Nerve blocks: Targeted injections of local anaesthetic near specific nerves can provide diagnostic information and therapeutic relief.
Epidural steroid injections: For nerve root pain (sciatica, radiculopathy) caused by spinal conditions.
Spinal cord stimulation: An advanced neuromodulation therapy for severe, refractory neuropathic pain that has not responded to other treatments. Electrode leads are placed in the epidural space to deliver mild electrical pulses that modulate pain signals.
Radiofrequency ablation: For certain nerve pain conditions, controlled heat can disrupt the targeted nerve's ability to transmit pain.

Multidisciplinary Support

Cognitive behavioural therapy (CBT): Helps reframe the relationship between mind and persistent pain, reducing the impact of pain on daily life.
Graded exercise and physiotherapy: Maintains function and prevents the deconditioning that often accompanies chronic nerve pain.
Sleep optimisation: Neuropathic pain often disrupts sleep, and poor sleep amplifies pain. Addressing sleep is a critical component of treatment.

Seeking Help for Neuropathic Pain in Perth

If you are experiencing burning, shooting, or tingling pain that may be neuropathic, ask your GP for a referral to Dr Ravi Agrawal at Cygnet Clinic, 109 Marine Terrace, Fremantle WA 6160. A comprehensive assessment can identify the cause of your pain and guide an evidence-based, individualised treatment plan.