I am 57 year old female with spinal stenosis. I wear size 48-50D. Can breast reduction help?

Yes it can help. Aggravating factors can make neck pain and nerve problems worse. But obviously breast reduction will not cure or help the spinal stenosis. More weight though on a problem area does not help and contributes to symptoms and may decrease pain. I would ask your neurologist for their opinion on your xrays, if severe, they may state it may not help.By itself, without spinal stenosis, breast reduction surgery has a 95% improvement in upper neck pain. But I do not know of studies combined with spinal stenosis.The difficulty will be insurance coverage. Most companies require amounts to be resected and a D cup might not be large enough, even going to a B cup, depending on your current  weight. Many use variations of the Schnur scare that require a certain amount of weight to be removed depending on your body BMI. It still can be done but then as a self pay outside of the hospital.

Sorry you have such a tough go with your back. Most women with overly-large breasts do have some back pain, but usually in the thoracic spine and shoulders. Still, having a breast reduction could help your back in general. Your insurance company may cover the surgery, but it will depend not only on your back pain status (as there is another reason for the pain) and your bra size, but also your height and weight figure into the equation for most insurers. So, see your local board-certified plastic surgeon for an examination and his/her opinion on whether this would be good for you. Good luck with your surgery.