Coccydynia is pain in and around the tailbone area.  It most often occurs after trauma to the area.  Females are affected more than males.  Other causes of coccydynia include arthritis, fracture or injuries sustained during vaginal delivery, bicycling or horse-back riding.  There is usually tenderness over the area which may radiate into the rectum.  Sitting usually worsens the pain.  Plain X-rays are indicated in all cases of coccydynia to look for fracture or tumors in the area.  Blood work may be necessary depending on the patient’s clinical presentation to look for other diseases such as various types of arthritis or bony tumors such as prostate cancer.  Diseases of the rectum or anus can be confused with coccydynia.  Proctalgia Fugax is another medical condition that can sometimes present in the same manner.  Treatment starts with conservative therapy including non-steroidal anti-inflammatories (NSAIDs), heat, ice and other physical modalities.  Injection of the sacro-coccygeal ligament with a dilute solution of a local anesthetic and a steroid may be useful as well.