Not long ago, a friend consulted me about her mother’s back pain for a month, which continued to worsen after treatment at a local hospital. She had heard that the orthopedic department at the Sixth People’s Hospital of Shanghai Jiao Tong University was very good and wanted to come over for further consultation and treatment. Professional sensitivity told me that such a patient needs to consider cancer bone metastasis. Cancer bone metastasis is a common cause of bone pain in advanced cancer patients, and is prone to occur in patients with lung cancer, breast cancer and prostate cancer. There are also some patients whose first symptom is bone pain and whose primary cancer lesions are only discovered later. Most bone metastases do not cause pain for a certain period of time. It is only as the disease progresses that pain gradually appears, at which time the patient’s family begins to go to the hospital for treatment. Bone metastatic cancer can occur in all parts of the body,8 and 80% of them occur in the vertebrae. Bone metastatic cancer pain is usually very serious, intermittent or continuous, and it is more obvious at night and gets worse day by day. The degree of localized pain in bone metastases ranges from dull pain to deep unbearable severe pain. After a bone scan, CT and MRI examination, my friend’s mother found that there were multiple vertebrae in the thoracic and lumbar spine that were mostly destroyed. There was a mass in the lung, which was confirmed to be a lung adenocarcinoma by bronchoscopic biopsy. Thus, the diagnosis of multiple bone metastases from lung adenocarcinoma was clear. Such a patient is always at risk of spinal fracture, and in the event of spinal fracture, the patient’s life would be in danger. Overall, this is a patient with advanced lung cancer with very serious complications, and if not handled properly, this patient’s life would be measured in days. The treatment of bone metastatic cancer pain is still a difficult problem faced by clinicians and is classified as refractory cancer pain. The principle of treatment should be a comprehensive and integrated treatment varying from disease to disease, including drug therapy, nerve block, nerve destruction, radiation therapy, nuclear therapy, chemotherapy and surgery. Along with treatment, attention should be paid to psychological treatment and active improvement of patients’ quality of life. Using strong long-acting opioids and non-steroidal anti-inflammatory drugs, pain can be well controlled in a significant proportion of patients if used appropriately. Although cancer can also cause general pain syndromes, the treatment of these syndromes is not practically difficult if cancer is the cause of the pain. Palliative radiotherapy, chemotherapy, and surgical treatment have promising applications in the palliative treatment of cancer pain.