What is the best treatment for "stable multilevel degenerative changes resulting in up to moderate bilateral neural foraminal stenosis at l4-5.

This is common in ol: Degenerative arthritis/changes are common in the joints between the various bones including your spine. When advanced, these changes can impinge on the nerves coming out from the spine(through the spaces between the vertebra called the Foramina). Most of these changes are silent but sometimes it can cause pain in the low back. Best treatment varies, from daily walks(best and simple) to physical

L4-5: First you should think if you are having any symptoms because of your back bone stenosis. If you are, then that will need to be dealt with. If you have no symptoms and the back bone sites are stable, then there is nothing to be done at this time. You might check with your orthopod or neurosurgeon regarding back braces for support.