About the Treatment

Pressure Specified Sensory Device (PSSD)

The Pressure Specified Sensory Device (PSSD) is the most accurate way of testing the lower extremity for sensory deficits because it can quantify and record both specific peripheral nerve threshold levels and peripheral nerve innervation density (which reflects axonal degeneration). As a result, the PSSD is able to identify pathologic changes in nerves at subclinical levels and it is pain free.


Traditional testing to determine if a person’s numbness or pain is due to compression (entrapment or pressure) of a nerve, injury to a nerve, or due to neuropathy is frequently unpleasant and painful.  Historically, there was no painless method for a doctor to determine if a person’s nerve was dying or coming back to life (regenerating).

Dr. Demetrio Aguila and Healing Hands of Nebraska, PC, now offers exactly that type of revolutionary painless nerve testing.

Why should I have PSSD testing? The PSSD can identify damaged nerves that may be causing:

  • Numbness, tingling, or pain in the feet or toes
  • Nighttime awakening due to foot pain
  • Clumsiness, weakness, or instability when standing or walking
  • Heel pain or pain in the ball of the foot

Following surgery to decompress a nerve, the PSSD can identify nerves that are:

  • Failing to heal (continued degeneration)
  • Healing properly (regenerating)

Is the PSSD cleared by the FDA? Yes! The PSSD is cleared for use by the Food and Drug Administration of the United States Government, and furthermore, it is approved by the National Institute for Standards and Testing.

How am I tested with the PSSD? You are seated comfortably in a reclining chair. The small blue PSSD is hand-held by the person doing the testing, and the two small, rounded, metal probes are touched gently to the skin area being tested.

Does PSSD testing have risks? Published outcomes of Neurosensory testing with the Pressure-Specified Sensory Device™ document that the PSSD offers the best hope to identify the source of your symptoms, to document the stage or degree of nerve compression or neuropathy, and to determine if your nerves are regenerating. There are risks, including identifying a problem which is not actually present, or failing to identify a problem that is present. Every Neurosensory test relies upon the cooperation of the patient during the testing procedure, the ability of the person doing the testing, and the interpretation of the PSSD results by the doctor in terms of the entire context of your clinical history and physical examination.

What is the surgery like? The surgery takes about one and one-half hours under general anesthesia and is performed as an outpatient. For the tarsal tunnel, an incision is made on the inside of the ankle. The tibial nerve is identified by releasing the thin ligament which forms the roof of the tarsal tunnel. The branching pattern of the tibial nerve is then identified. Each of the three main branches of the tibial nerve has its own fibrous tunnel that must then be released. Scarring within the nerves in each tunnel can then be removed with microsurgery (internal neurolysis). Local anesthesia is placed into the skin, so the toes and bottom of the foot may be numb for a few hours, but there will be little pain after the surgery. You can walk using a walker or crutches immediately after surgery. The bandage is removed after one week. You will continue using a walker or crutches for three weeks, which is when the sutures are removed. Two other nerves are often decompressed when necessary, the common peroneal nerve on the outside of the leg below the knee and the deep peroneal nerve on the top of the foot.

Surgery on the Tarsal Tunnels: The steps in decompression of the four medial ankle tunnels for treatment of tarsal tunnels syndrome:

  • (a) The Tarsal tunnel is opened.
  • (b) Roof of the medial plantar tunnel is open.
  • (c) Roof of the lateral plantar tunnel is open.
  • (d) Septum between tunnels is divided and the calcaneal tunnel is opened.
  • (e) Septum is removed to create a large tunnel, completing the decompression of the four medial ankle tunnels.

What are the risks of surgery? There are risks associated with every surgical procedure, such as the risk of anesthesia, bleeding and infection. Complications unique to decompression of the four medial ankle tunnels are:

  • Unpredictable nature of the healing process (scar formation, swelling).
  • Painful scar due to entrapment of a nerve to the skin.
  • Walking after surgery can cause sutures to break.
  • Wound healing can take longer if you are a diabetic.
  • There may be remaining numbness in the toes or heel.
  • Nerve regeneration can be painful.
  • It may take up to one year to achieve maximum relief.

Who should do this surgery? Surgeons trained at Healing Hands of Nebraska have the most advanced training and experience doing this surgery, which offers you the best chance for success.

Download our Healing Hands PSSD Resource PDF for more information.

The Aguila Team Can Help

Dr. Demetrio Aguila and his team at Healing Hands of Nebraska can help patients suffering from unexplained nerve pain or other chronic pain. We urge everyone to not ignore symptoms when solutions may be possible. Take the first step to feeling better, come and see us about solutions for chronic pain, allergies, and reconstructive surgery.

Call us at 1-402-370-9515 or fill out the form on this page to set up a consultation to determine your best options.

Contact Dr. Aguila

1 + 0 = ?