Bone drilling (BD) is reconsidered to be a novel treatment for pain including vertebral compression fracture (VCF), vertebral spondylosis, osteoarthritis (OA), and osteonecrosis of the knee and hip, and neuropathic pain. BD is simple and harmless. The technique of BD is similar to that of bone marrow puncture. BD is conducted under X-ray fluoroscopy and regional anesthesia. Exact penetration of the bone cortex is required for intramedullary decompression, and sufficient aspiration of medullary blood is important to eliminate intramedullary inflammatory cells (ICs) and inflammatory chemical mediators (ICMs).