Not always. The pain in the coccyx is mostly associated with an injury to the coccyx itself or the surrounding muscles and tissues. However, a long-lasting pain, which does not go away even after the primary treatments, should be suspected for either an infection or a tumor. Early prognosis can help find the root cause of the pain.
Some of the methods include getting an X-ray or MRI scan done to check for any signs of injury on the bone or tissues surrounding it. This will also help analyze if there is a tumor that is pressing against the bone, causing the pain. Also, if the tailbone pain is associated with other symptoms, such as weakness, numbness near the groin area, in particular, tingling sensation on your limbs, etc., you should seek medical assistance as these are few of the symptoms of Chordoma, the bone cancer.
However, before suggesting an X-ray or MRI, your doctor will also check around the area to check for any growth that might be putting pressure on the coccyx. Moreover, the pain associated with tailbone cancer is usually sharp-shooting and will get worse with every movement.