There are several different causes of coccyx or “tailbone” pain. Most commonly this stems from a slip or fall causing trauma to the sacrococcygeal joint. Ultrasound-guided injections of the sacrococcygeal joint and surrounding ligaments, or x-ray guided injections of the joints and surrounding nerves (or ganglion) can be quite relieving and also facilitate improved response to conservative therapies with joint mobilization or pelvic floor strengthening.