Spinal stenosis is a common problem in the elderly population. Thanks to better knowledge it is being diagnosed more frequently and in many cases successfully treated by surgery. Clinically, patients with a lumbogluteal and in later stages bilateral sciatic pain syndrome can be differentiated from patients with monoradicular pain. Typically, the posture deteriorates with walking distance. Spinal stenosis must be differentiated from peripheral vascular disorders and compressive disc herniation. The possibilities of conservative therapy are limited and their effect is lasting only in mild cases.