The authors present the case of a sacral chordoma in which the diagnosis was delayed as the patient was diagnosed and treated as coccydynia. Persistent, severe coccydynia following minor trauma is common but the symptom can also be caused by significant underlying disease. The correct diagnosis was made in this patient but after significant delay. The presentation of this case involved multiple specialties and provides several learning points regarding the importance of thorough history taking and clinical examination. It highlights the importance of 'red flag' symptoms of low back pain which need to be fully investigated.