Bone metastasis is an advanced stage of malignant tumor disease progression, especially common in breast cancer, prostate cancer, lung cancer, colorectal cancer and other tumors, and its incidence is as high as 15% to 70%. The pain associated with bone metastasis often seriously interferes with the patients’ ability to live and affects their quality of life. A comprehensive treatment strategy should be adopted for bone metastases from malignant tumors, including systemic antitumor therapy, pharmacological analgesic therapy to relieve pain symptoms, bisphosphonate therapy to prevent and reduce bone-related events, radiation therapy to relieve compressive neuralgia or reduce the risk of weight-bearing bone fracture, and surgical treatment to restore body function if necessary. I. Systemic anti-tumor therapy Bone metastases are mostly local manifestations of systemic tumor metastases, and systemic therapy for tumors should be the main choice for treatment and control of tumors. We must realize that the pain of bone metastasis is caused by the progress of malignant tumor, and only when the systemic antitumor treatment is effective, the pain can be controlled fundamentally, so we must regard the antitumor treatment as the most important basic treatment of analgesic treatment, and only the analgesic treatment based on this foundation can bring long-term pain control to patients. In clinical practice, we often compare “analgesic treatment” to “crutches” when fracture is healed, and there will be no need for “crutches”. B. Standardized treatment of analgesic drugs As a special type of pain, bone metastasis pain should also follow the principles of standardized treatment of pain. The assessment of cancer pain mainly includes two aspects: the nature and degree of cancer pain. At present, cancer pain is mostly divided into three categories: somatic pain, visceral pain and neuralgia. The pain of cancer patients is mostly mixed in nature, and the use of multidimensional pain assessment scale helps doctors to understand cancer pain more comprehensively. The assessment of cancer pain level is relatively simple, but attention should be paid to the assessment of elderly, patients with speech or cognitive dysfunction. Bone metastasis pain often includes dull pain due to local injury of bone metastasis, nerve compression pain due to structural changes at the site of bone metastasis, and pain due to pathological fracture, and it is especially important to conduct detailed pain assessment because these types of pain are handled in different ways. (i) Preferred noninvasive route of administration (ii) Administration by step: It means that the selection of analgesic drugs should be based on the degree of pain, from mild to severe, with different strengths of analgesic drugs. Mild pain: the first step of NSAIDs is preferred, represented by aspirin; moderate pain: weak opioids, represented by codeine, can be combined with NSAIDs; severe pain: strong opioids, represented by morphine, can be combined with NSAIDs. The combination of the two types of drugs can increase the pain-relieving effect of opioid drugs and reduce the dosage of opioid drugs. At the same time of the step medication, you can choose tricyclic antidepressants or anticonvulsants and other adjuvant medications according to your condition. (3) Timely medication: It means that pain medication should be given regularly at the prescribed time, not when the patient asks for it. When using pain medication, the dose that can control the patient’s pain must be measured first, and the next dose should be given before the effect of the previous dose disappears. When a patient has a sudden onset of severe pain, pain medication can be given as needed to control it. (iv) Individualized dosing: There is no ideal standard dose of opioids, there are obvious individual differences, the dose that can make pain relief is the correct dose. When opioids are used, the dose should start from a small dose and gradually increase until the dose that relieves pain and has no obvious adverse effects is the individualized dose. (v) Pay attention to specific details: Patients using analgesics should be monitored, the degree of pain relief and physical reactions should be closely observed, and necessary measures should be taken in time to reduce the adverse effects of drugs and improve the analgesic treatment effect. III. Bisphosphonate therapy Hypercalcemia, bone pain and bone-related events are common complications in patients with bone metastases, which will seriously affect patients’ quality of life, aggravate their psychological pressure and shorten their survival time. Bisphosphonates are important drugs of choice for patients with bone metastases, which can effectively treat hypercalcemia caused by malignant tumors, and can effectively treat advanced tumor bone metastases, and have significant efficacy in reducing the incidence of bone-related events (SRE) in patients with bone metastases. The third-generation bisphosphonates zoledronic acid and ibandronate are superior to the second-generation drug pamidophosphate disodium in controlling bone metastasis pain. However, during the application of bisphosphonates, attention should be paid to the prevention of their toxic side effects, especially osteomyelitis of the mandibular mandible, and it is recommended that patients should consider oral examination before using bisphosphonates, and during the treatment, patients should avoid oral manipulation as much as possible. IV. Local treatment Fracture is a serious concomitant event of bone metastasis. For patients with bone metastases in weight-bearing parts of the spine, femur, and humerus, radiation therapy is often used as an important treatment option to provide rapid relief of bone pain and reduce the risk of pathological fracture. In addition, advances in orthopedic surgical techniques have provided more treatment options for patients with bone metastases, including bone injury site fixation, lesion bone replacement, and release of compressed nerves.