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It’s a noun occasionally used in pathology meaning a pain in the buttocks. So if you say that someone gives you pygalgia you are saying in a polite and technical way that they are a pain in the arse.
“How would you describe Malcolm?”
“Pygalgia!”
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Originally a medical term used to describe the pain associated with piles, now used to describe someone who is a pain in the arse. See also rectalgia.
Malcolm must think the boss is suffering from piles, he's got his head so far up the boss's arse it's a suppository.
I don't know about the boss, but Malcolm gives me pygalgia.