What is the main difference between peripheral neuropathy and spinal stenosis?

Several: Peripheral neuropathy tends start in the toes, moving up the limbs with worsening, and in a circumferential distribution. Spinal stenosis symptoms typically start at the back/buttock, radiates down the limb, in a band-like pattern(sciatica), and worsens with extension of the spine.

Cause: Peripheral neuropathy is related to compression of peripheral (in arm or leg) nerve or due to an underlying issue like diabetes, vitamin deficiencies, toxic substance exposure, traction or fracture or crush injury, aging, chemotherapy etc while spinal stenosis occurs due to compression of spinal cord/thecal sac/spinal nerves within the spine. Neuropathy pain tends to be constant & not positional.