### What you need to know Lumbar spinal stenosis (LSS) affects about 11% of the population,1 and primarily affects older adults.1 Pain in legs and difficulty walking can limit function and participation in daily activities, which can have negative psychological effects.2 Diagnosis can be challenging because of the overlap of symptoms with other conditions that cause leg or low back pain in older adults. Lumbar spinal stenosis can usually be diagnosed clinically and managed conservatively in primary care. Patients with severe symptoms may require referral for imaging and intervention. The evidence for most treatment options is limited.345 Shared decision making with patients must consider the severity of symptoms and their impact on the person’s life, risks and benefits of treatments, and individual preferences. Degenerative changes in the spine can cause narrowing of the central spinal canal, lateral recesses, or intervertebral foramen. Changes include disc degeneration and bony or soft tissue changes, such as facet joint arthrosis and hypertrophy of the ligamentum flavum, …