Whether you’re experiencing testicular pain that is acute and intermittent or chronic and persistent, knowing the causes of testicular pain can help you properly diagnose and treat it. Here’s what you should know.

What do we mean by testicular pain?

The testicles are male reproductive organs located in the scrotum. Testicle pain may occur due to injury or conditions in the testicles themselves. It may also occur as referred pain from a condition elsewhere in the body, from the groin, or any of the anatomical structures surrounding the testicles.

These structures include the epididymis, the duct that moves sperm through the vas deferens, which is located just behind the testes. There’s also the pampiniform plexus, a network of veins that enervates the entire reproductive structure.

Even minor injury can cause discomfort and pain at any age. It can be felt in a variety of ways, including:

  • Chronic, persistent soreness
  • Acute, sharp pain
  • Intermittent pain

What causes testicular pain?

Regardless of the type of pain you’re experiencing, most sufferers just want to know what causes testicular pain and how to address it.

The most common causes of testicular pain are:

  1. Trauma
  2. Varicoceles
  3. Epididymitis
  4. Undescended testicle
  5. Inguinal hernia
  6. Kidney stones
  7. Orchitis
  8. Testicular torsion
  9. Gangrene
  10. Post-vasectomy pain syndrome
  11. Testicular tumors

Let’s look at each of these in more detail, along with details on treatments for each one.

1. Trauma

Trauma to the scrotum is the most common cause of testicular pain. This may occur during contact sports or as an accident.

Treating trauma

Although it may feel catastrophic when it occurs, pain due to mild trauma to the scrotum should recede gradually. You can apply ice, if necessary, or take ibuprofen or naproxen sodium for pain.

Note that if your pain does not recede after an hour and/or you experience significant swelling or severe pain, this could be an emergency. Seek immediate medical care.

2. Varicoceles

Varicoceles is an enlargement of the veins in the scrotum (similar to varicose veins in the legs).

This condition can occur at any age and may slow testicle development or cause the testicles to shrink. In some cases, varicoceles can also lead to low sperm count.

Treating varicoceles

The majority of varicoceles do not require treatment. However, if they cause painful symptoms, surgery may be necessary.

If varicoceles cause a decrease in sperm count that is hampering fertility, surgery is also an option.

3. Epididymitis

Epididymitis is an infection of the epididymis, the duct that sperm travels through. This infection is most commonly caused by sexually-transmitted infections (STIs), like chlamydia and gonorrhea. In older men, an enlarged prostate gland can also cause this type of infection.

Onset of epididymitis is gradual, with pain, redness, and swelling developing over time. In addition to pain, sufferers of this type of testicle pain may also experience:

  • Nausea and vomiting
  • Fever
  • Pain when urinating
  • Pain during sexual intercourse

Treating epididymitis

As with other types of infections, antibiotics are typically the treatment of choice for epididymitis. Comfort measures such as ice can be applied to the scrotum. Your doctor may recommend non-steroidal anti-inflammatory medications for pain and swelling.

When it comes to STDs, prevention is key. Practice safer sexual intercourse to prevent this cause of testicular pain from recurring.

4. Undescended testicle

When male babies are in utero, their testicles develop in their abdomen. Shortly after birth, their testicles descend into the scrotum and continue to develop there.

If a testicle does not descend within a year of birth, this undescended testicle can become twisted, cutting off blood supply and causing pain.

Treating undescended testicle

The “wait-and-see” approach is often the most helpful treatment for undescended testicle in children. If the testicle does not descend, treatment with hormones may cause them to descend.

As a last resort, the undescended testicle can be treated surgically.

5. Inguinal hernia

An inguinal hernia is a type of hernia that occurs as a result of muscle strain. When lifting something heavy or straining, tissues push through weak abdominal muscles into the scrotum, causing swelling and pain. You may also see a visible bulge on the side of the pubic bone and feel a burning sensation near that bulge.

Newborn babies sometimes develop an inguinal hernia when they cough with weak muscles. Older children can cause a hernia if they strain during bowel movements.

For all ages, pain may be accompanied by:

  • Nausea and vomiting
  • Fever
  • Suddenly intense pain
  • An inability to have a bowel movement or pass gas

Treating inguinal hernia

In many cases, your doctor may be able to push the tissue back through the abdominal muscle. Rest and over-the-counter medications for any lingering pain, plus core strengthening exercise is prescribed when this treatment is successful.

Children who struggle with bowel movements may be given a stool softener and increased hydration. For severe hernias that cannot be repaired this way, surgical repair may be necessary.

6. Kidney stones

Stones occur in the kidneys when mineral and salt deposits form crystals that then move through the urinary tract. Although these stones can be small in size, the effect they produce as they move through the narrow urinary tract can affect the body powerfully, with sharp pain that radiates throughout the lower abdomen and groin. Urine may be discolored and foul-smelling, and the pain may be enough to cause nausea and vomiting.

Additionally, those with kidney stones may feel the need to urinate, but may not be able to do so. Symptoms vary as the kidney stone passes through the urinary tract.

Treating kidney stones

Unfortunately, the most common treatment for kidney stones is the axiom: “this too shall pass.” The first-line treatment for kidney stones is to wait for them to move out of the body, aided by copious amounts of fluids and over-the-counter pain medications.

In some cases, kidney stones can become lodged in the urinary tract and require surgery, but this is not usual.

Prevention is the best treatment. Stay hydrated to keep mineral and salt levels in the urine stable and healthy. If your pain is severe and accompanied by fever, chills, nausea, or vomiting, contact your doctor immediately.

7. Orchitis

Orchitis is one of the causes of testicular pain that can occur as a result of not seeking treatment for earlier symptoms. What starts as a minor infection can quickly become a fertility-threatening event if left untreated. Orchitis is a bacterial or viral infection caused by an STI (or the mumps, in some cases).

Symptoms of orchitis include:

  • Swelling in either or both testicles
  • Mild to severe pain (that may change as the condition progresses)
  • Fever
  • Nausea or vomiting

Treating orchitis

As with most infections, this type of testicle pain is treated with antibiotics. Comfort measures such as ice and fever reducers can also help ease pain.

Because the symptoms so closely resemble testicular torsion (as we’ll discuss next), it is important to seek immediate medical attention for orchitis.

8. Testicular torsion

This condition is serious and requires emergency medical attention. Testicular torsion is a condition that occurs when the testicle becomes twisted around the spermatic cord.

Diagnosed most often in men under the age of 25, testicular torsion typically occurs on the left side. Symptoms of testicular torsion include:

  • Redness in the scrotum
  • Scrotum darkening
  • Swelling
  • Minor pain that becomes suddenly severe on one side of the scrotum
  • Vomiting

Symptoms may not occur suddenly but can instead appear and get gradually worse over several days.

Treating testicular torsion

The treatment for testicular torsion is surgery to correct the twisted testicle.

In severe cases, the damaged testicle must be removed. Note that this does not typically affect fertility.

9. Gangrene

Gangrene is tissue death that can happen anywhere in the body. This occurs when blood flow to the testicle is cut off. Testicular torsion can cause gangrene if left untreated, as can orchitis or any other infection in the testicles. There are three types of gangrene:

  • Dry gangrene: Occurs when tissues are not getting enough oxygen
  • Wet gangrene: Usually caused by bacterial infection
  • Gas gangrene: This type of gangrene is caused by a specific type of bacteria (clostridia)

The risk of gangrene in a healthy adult is generally low, but other conditions can increase your chances of developing it. These can include:

  • Diabetes
  • A compromised immune system
  • Lifestyle choices, such as smoking

Common symptoms of external gangrene (visible on the outside of the body) include isolated cold temperature on the testes, lack of feeling, and skin that is an unusual color (e.g., green-black or blue).

Internal gangrene occurs inside the testicles and is more likely to cause pain, unexplained fever, and lowered blood pressure.

Treating gangrene

If it is bacterial, gangrene can be treated with antibiotics. Surgically correcting testicular torsion may be sufficient to bring blood and oxygen back to the affected structures in the groin. In some cases, surgery to remove the dead tissue is necessary along with other treatments.

For testicles that cannot be saved, removal may be necessary.

10. Post-vasectomy pain syndrome

Once pain from a vasectomy recedes, some men may experience post-vasectomy pain syndrome. This condition can develop immediately after vasectomy or may occur in the years that follow. It can be incredibly frustrating to diagnose and treat, as there is not always a clear physiological diagnosis.

Some men report feeling pain, pressure, and heaviness in the epididymis, while others have a persistent ache in the entire scrotum.

Post-vasectomy pain treatment

There is no one approach to this type of testicle pain. A comprehensive treatment plan might include pelvic floor therapy, acupuncture, and a psychological evaluation to begin. When necessary, surgical options can include:

  • Repeat vasectomy
  • Denervation of spermatic cord
  • Vasectomy reversal

Fortunately, this is one of the causes of testicular pain that is rare.

11. Testicular tumors

Finally, testicular tumors can cause significant pain and distress in those who suffer. They are also very rare.

In addition to pain that can be dull and aching or sharp, symptoms may include heaviness and aching in the lower abdomen.

Treating testicular tumors

Typically, this type of testicle pain is managed by treating the underlying condition and utilizing comfort measures such as pain medications (either over-the-counter or prescribed) as well as ice and warm baths.

For tumors that are unresponsive to treatment, surgical removal is often necessary and can be life-saving.

When should you go to the doctor for testicle pain?

Because testicle pain can be extreme, even with what might otherwise be considered a mild trauma (e.g., a slight blow to the testicles, such as might occur while mountain biking), it’s important to know when to seek treatment. Not every injury requires emergency medical care.

Call your doctor for a non-emergency appointment if you have any of the following symptoms:

  • A lump anywhere on the scrotum
  • A fever that accompanies testicle pain
  • Your scrotum is red or warm to the touch
  • You experience testicle pain and have been in contact with someone diagnosed with an STI or mumps

On the other hand, testicular pain can be a sign of a serious, potentially life- or fertility-threatening issue that is considered an emergency. Seek immediate medical care if you experience sudden or severe testicle pain that is accompanied by nausea or vomiting. If you suffer an injury to the testicles and the pain does not decrease after an hour or is accompanied by swelling, seek emergency medical attention.

Get help for testicular pain

A pain specialist can help identify the causes of testicular pain and work with you to develop an appropriate treatment.

You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

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