Reviewed for medical accuracy by Dr Evelyne Jonniaux, Medical Advisor
Last updated 17 September 2026
In December 2025 the French health authority recognised force-plate posturography, but for neurological disorders, vestibular disorders and older people at risk of falls. Musculoskeletal pain is not among the accepted indications, and the ruling states that the test does not replace clinical examination.
The questions we get asked
Is the platform measurement reliable?
Yes, under precise conditions that are rarely met in practice. A systematic review of 32 articles finds acceptable reliability in 81 percent of them, but from 90 seconds of recording, averaged over three to five runs. A single 30 or 50 second recording, the common protocol, does not meet those conditions. No single parameter proved more reliable than the others.
A 2025 review separately notes the absence of normalised reference values, because protocols and software differ. There is therefore no validated threshold above which an asymmetry counts as abnormal.
Do people in pain sway more?
On average yes, and it is well documented: across 16 studies comparing people with low back pain to healthy controls, 14 find increased sway. But the decisive point lies elsewhere. No correlation could be identified between sway amplitude and pain intensity, location or duration.
A group difference does not make an individual diagnostic test. That is the most common confusion on this subject.
Does excessive lordosis cause back pain?
A meta-analysis of 796 people with back pain and 927 controls finds the opposite of the traditional teaching: lordosis is smaller in people with back pain, not greater. And because the studies are observational, the direction of causality is not established: pain can flatten the curve as readily as the curve can cause pain.
What about the link between dental occlusion and posture?
It is a theoretical pillar of multisensory posturology. An analysis of 355 articles on the relationship between orthopaedic and dental findings finds 0.8 percent randomised trials, and half the publications at the lowest level of evidence. After reanalysis of the 12 available stabilometric studies, no clinically relevant correlation was found.
What about postural insoles themselves?
The randomised trials published under that term involve 10 to 24 subjects, in cerebral palsy or hemiparesis, and measure gait or balance parameters, never musculoskeletal pain in a non-neurological adult, which is nonetheless the dominant commercial indication. In the only three-month trial with a withdrawal phase, the gains disappear one month after the insoles are stopped.
What the figures say
| Finding | Figure | Source |
|---|---|---|
| Minimum recording for acceptable reliability | 90 seconds, 3 to 5 runs | Ruhe et al., Gait Posture, 2010 |
| Studies finding increased sway in back pain | 14 of 16 | Ruhe et al., Eur Spine J, 2011 |
| Correlation between sway and pain intensity | none | Ruhe et al., 2011 |
| Lordosis in people with back pain | smaller, not greater | Chun et al., Spine J, 2017 |
| Randomised trials in the occlusion and posture literature | 0.8 percent of 355 articles | Hanke et al., J Orofac Orthop, 2007 |
| Accepted indications for posturography | neurology, vestibular, falls in older people | Haute Autorité de santé, December 2025 |
One figure we could not source, and it is widespread: “80 percent of chronic pain is postural in origin”. No publication supports it, in any formulation, in any database searched.
What Noria Health does, and does not do
We organise a consultation with a specialist team near Brussels when a balance disorder or repeated falls justify assessment, directing it to neurology or ENT according to the picture. Feasibility confirmed within 24 to 48 hours.
We do not offer postural assessment as a first-line test for pain, we do not prescribe postural insoles, and we do not call into question care already under way.
Who reviewed this page
Noria Health editorial team.
See also: all our articles on posturology and podiatry.
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