Testicular Pain

//Testicular Pain
Testicular Pain 2018-10-16T14:21:29+00:00

What Is Testicular Pain?

Pain in the testicles, or testicular pain, is a relatively common condition in men. If you’re suffering from this type of pain, know that there can be many different causes for it and treatments that can help. Here’s what you should know.

Testicular pain can be acute, which means it starts suddenly and resolves over a couple weeks, or it can be chronic. Chronic testicular pain lass for three months or more, beyond the normal expected timeframe after an injury or surgery. In some cases the pain can be low intensity. Chronic testicular pain may also be resistant to treatment.

The type of pain you’re suffering from will influence which treatment approach works best. Many cases of testicular pain, however, can be managed with the help of your doctor.

Testicular Pain Causes

There are a few testicular pain causes, including:

  • Injury
  • Hernia
  • Infection
  • Prostate swelling
  • Cancer, in rare cases

Most often, acute testicular pain occurs from an injury to the testicles. These injuries are usually not serious, but pain can indicate a more serious underlying condition. For example, some types of pain may point to:

  • Testicular torsion, in which the testicles twist within the scrotum
  • Strangulated inguinal hernia
  • Testicular tumor with infection, infarction, or rupture

Because of this, if you’re experiencing unexplained testicular pain for more than a few days, it’s wise to talk to your doctor. They can help you determine the underlying cause of your pain.

This is especially important for pain that results from infection in the outer cellular layer of the testicles, also called the epididymis. This type of infection is referred to as epididymitis. Inflammation or infection of the testicles is called orchiditis. In some cases, these conditions are related to swelling in the prostate, particularly in older men. Other testicular pain may be traced back to sexually transmitted infections.

Finally, in rare cases, chronic pain in the testes can be the result of cancers in the prostate, lower back, or testicles. Related to this, radiotherapy or chemotherapy can also cause pain in the testicles due to nerve damage, a side effect of the treatment.

Testicular Pain Treatments

If you’re suffering from testicular pain, your first step should be talking to your doctor. They can diagnose the underlying cause of your pain with a physical examination and series of questions. Answer all of their questions thoroughly and honestly. Make sure to mention any other symptoms you’ve been experiencing and how long the pain has lasted.

Some types of testicular pain, such an injections, can be treated with antibiotics. Injuries may resolve after a few weeks of rest. If you’re suffering from chronic testicular pain that doesn’t resolve with these treatments, your doctor may recommend other pain relief therapies.

Testicular pain medications

Your doctor may begin with conventional medical treatments, which usually includes oral painkillers or non-steroidal anti-inflammatory medications. Typically, over-the-counter medications like aspirin or ibuprofen can control pain and inflammation. For more severe cases, your doctor may prescribe antidepressants, anticonvulsants, or opioids as a last resort in the most severe cases.

There are side effects to using medications, which include organ damage from long-term or excessive use, drug addiction, drug tolerance, or gastrointestinal damage with prolonged use. Pain medications can reduce pain symptoms but they do not address the underlying cause of your pain. Because of this, they’re best used in combination with other treatment approaches to permanently alleviate your pain.

Nerve blocks 

Individuals who suffer with chronic testicular pain from cancers or related treatments may experience successful pain relief with nerve blocks.

To perform a nerve block, your doctor will inject a local anesthetic and steroids directly to the spinal cord nerves that are responsible for your pain. These are typically done in the lumbar or sacral region, which controls the electric impulses that transmits pain signals to the brain from the testicles.

Nerve blocks can result in immediate pain relief. These results may last for a few weeks or a few months, depending on the patient.

Radiofrequency ablation 

If a nerve block fails to control your pain, your physician may recommend radiofrequency ablation.

During a radiofrequency ablation procedure, your doctor uses a local anesthetic to numb the treatment area. They’ll then insert a thin probe through the skin to the spinal nerves that are responsible for transmitting pain. This probe delivers precisely targeted electro-thermal impulses that destroy the nerves responsible for transmitting pain.

Like any interventional approach, there are risks, though they are rare. Radiofrequency ablation risks include infection, bleeding, and unintentional damage to the motor nerves that could result in paralysis in severe cases.

You can learn more about this treatment approach in the following video.

Spinal cord stimulation 

Another choice for pain control is a spinal cord stimulator (SCS). This is a state-of-the-art medical device that may help with your pain when other, more conservative, methods have not been successful.

Spinal cord stimulators use thin wires made of flexible material to conduct electrical impulses to the spinal cord nerves that transmit pain signals to the brain. Your doctor will likely start with a trial stimulator. This assesses whether or not the device could help with your pain and usually lasts several days to several weeks. If treatment with the temporary device is a success, your doctor will implant more permanent device.

Your doctor will implant the stimulator at a medical facility, but it’s usually done as a fairly fast outpatient procedure. Afterwards, you’ll be able to use an external hand-held controller to deliver pain-blocking impulses to the nerves responsible for your pain.

Spinal cord stimulators are very safe and can be easily removed in an outpatient procedure if the pain resolves or the machine malfunctions. Again, though, like any interventional procedure there are risks. The most common risk with spinal cord stimulators is an infection where the device is installed. You may also experience the development of scar tissue around the implanted wires that could cause additional inflammation and pain.

During implantation of a spinal cord stimulator, patients might also experience bleeding or leakage of cerebrospinal fluid from the area of the incision, in rare cases. Further, if the electrode’s placement does not cover enough of the area, the treatment may fail. Although there are risks, the device has been very effective in reducing or eliminating chronic testicular pain. Working with a specialist with advanced experience installing spinal cord stimulators can help you avoid some of these risks.

Conclusion

Testicular pain can occur due to a number of reasons, including injury, infection, or certain cancers, in rare cases.

Conventional treatments may include rest and over-the-counter medications to manage the pain. Over the long-term, chronic testicular pain can point to prostatic inflammation, enlargement, or malignant tumors. These chronic pain conditions may be treated with nerve blocks in the lumbar or sacral spine areas, radiofrequency ablation, or spinal cord stimulation. Although painful and distressing, most testicular pain conditions are treated successfully.

Do you need help managing your testicular pain? 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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References

  1. Srinath H. Acute scrotal pain. Australian family physician. Nov 2013;42(11):790-792.
  2. Peng B, Li D, Pang X. Degenerative Lumbar Spondylolisthesis with Testicular Pain. Pain medicine (Malden, Mass.). Oct 4 2013.
  3. Pogorelic Z, Mrklic I, Juric I. Do not forget to include testicular torsion in differential diagnosis of lower acute abdominal pain in young males. Journal of pediatric urology. Dec 2013;9(6):1161-1165.
  4. McJunkin TL, Lynch PJ. Sacral nerve stimulation as a treatment modality for intractable neuropathic testicular pain. Pain physician. Nov-Dec 2009;12(6):991-995.
  5. Ng YH, Ho HS, Kumar NS. Acute cord compression secondary to spinal relapse of testicular seminomas. BMJ case reports. 2013;2013.
  6. Nouri KH, Brish EL. Spinal cord stimulation for testicular pain. Pain medicine (Malden, Mass.). Sep 2011;12(9):1435-1438.
  7. Misra S, Ward S, Coker C. Pulsed radiofrequency for chronic testicular pain-a preliminary report. Pain medicine (Malden, Mass.). May-Jun 2009;10(4):673-678.

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