Medical professionals may clinically diagnose lumbar spinal stenosis using a combination of a thorough medical history, physical examination, and imaging (CT or MRI). EMG may be helpful if the diagnosis is unclear. Useful clues that support a diagnosis of LSS are age; radiating leg pain that worsens with prolonged standing or walking (neurogenic claudication) and is relieved by sitting, lying down, or bending forward at the waist; and a wide stance when walking. Other helpful clues may include objective weakness or decreased sensation in the legs, decreased reflexes in the legs, and balance difficulties, all of which are strongly associated with LSS. Most people with LSS qualify for initial conservative non-operative treatment. Nonsurgical treatments include medications, physiotherapy, and injection procedures. Decompressive spinal surgery may modestly improve outcomes but carries greater risk than conservative treatment. Overall, there is limited supporting evidence to determine the most effective surgical or nonsurgical treatment for people with symptomatic LSS. Evidence to support the use of acupuncture is also limited.