@gocy Could you be more specific about where your spinal stenosis is? If you have shoulder pain, it may be in the cervical area. Is it spinal cord compression and/or compression of the nerves that exit the spinal cord between the vertebrae?

PT can help strengthen the core muscles which help to support the spine, and with anything spine related, posture is very important. That may reduce symptoms and buy some time without surgery. If the PT fails, that may be an indication that surgery is needed.

If you find yourself on a track toward surgery, it helps to get several opinions before making a decision. Some surgeons are all too eager to operate, and others take a conservative approach and want to make surgery that you would have enough benefit from surgery to balance against the risks from the surgery.

I would suggest writing down your symptoms. Describe your pain and how it changes when you change body positions, such as sitting, laying down, standing, etc. Does a specific movement increase or decrease pain? Ask a surgeon how they know that your specific pain is related to a specific spine problem, and what tests do they need to do to confirm this? Something may seem like a spine problem, and could be pain caused by a nerve elsewhere in the body where it could be compressed. Pain felt along the nerve feels the same and it may be hard to determine exactly where the problem is. That is where a neurologist can help with testing. Some of that is uncomfortable, but they can help narrow down a problems and exclude other problems that have similar symptoms. A physical therapist can also explain a lot and help you formulate questions for your surgeon based of what they see when they evaluate you. They often rehab patients after surgery and know about specific surgeons in the area.