Coccydynia is a common condition that is often self-limited and mild. Although the vast majority of patients who seek medical attention respond to conservative treatments, some patients require more aggressive treatments. In these cases, the etiology of the coccydynia may be complex and multifactorial. A multidisciplinary approach employing physical therapy, ergonomic adaptations, medications (NSAIDs), injections, and, possibly, psychotherapy leads to the greatest chance of success in these patients. Surgical coccygectomy generally is not recommended, and although different surgical techniques are emerging, more research is needed before their efficacy can be established.