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 the similar to that of bone marrow puncture. BD is conducted under X-ray fluoroscopy and regional anesthesia. Exact penetration of 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). Onset of the effect is immediate, and the effect lasts several months or a few years. However, precise of the underlying mechanisms of BD remains unclear.