Bone pain and pathological fractures due to spinal metastases result in severe disorders of ADL (activities of daily living). Osteoclastic pathology by metastases is local bone metabolism disorders by an activation of osteoclast by oncocyte. Therefore, early detection and treatment are important, and radiation therapies and stabilization surgeries have been performed as local treatment. Bisphosphonate therapy to plan pain relief and prevention of enlargement of metastases came to be performed recently by depression of bone resorption. We should aggressively perform combination therapies against bony pain due to metastases.