Pelvic pain of anorectal origin should be carefully investigated. The
detailed clinical history may be sufficient to establish diagnosis and
determine the etiology of anorectal pain. The diagnosis should be con
firmed by complementary clinical investigations. The diagnosis of esse
ntial anorectal pain can be established only after failure of measures
instituted to correct organic lesions and if pain persists. Among typ
es of essential anorectal pain, coccygodinia and nervus pudendus entra
pment are responsive to precise and effective management.