Spinal stenosis mainly is a disease of the elderly patient. Mostly the lumbar spine is affected. The assessment is based on the typical constellation of symptoms (neurogenic claudication, subjective weakness) and physical findings (abnormal reflex status, loss of strength, sensory deficits). It further is supported by the radiographic proof of stenosis of the spinal canal, the lateral recess and the intervertebral foramina. The targets of physical therapy are the relief of pain and an improvement concerning the activities of daily living, which are especially impaired by reduced walking distance and difficulties in climbing stairs as well. That can be achieved by physiotherapy treatment of myofascial disorders oral medication/local injection.