Osseous manifestations are a relevant side effect of tumours as they provide the basis for complications. The work presented here was developed within the framework of the S3 guideline "Supportive therapy in oncological patients" and provides an overview. A total of 3564 studies were found. In the case of osseous metastases of the spinal column, it was found that a single dose of 8 Gy radiation and fractional radiotherapy bring about a comparable reduction in pain. Furthermore, repeat radiation can take place and achieves a good pain response in about half of patients. Radiation is also recommended after surgical decompression of a spinal cord compression (B, 1b). If compression of the spinal canal has not yet occurred, but there is a risk of fracture, or if a fracture is already present or pain is resistant to therapy, kyphoplasty can be undertaken (0, 1b). Radionuclide therapy can reduce pain in cases of multifocal metastases (0, 1b).