10 Common Causes of Testicular Pain and How To Prevent Them
Published: Apr 21, 2022

There are many causes of testicular pain, and therefore it is not unusual for people with testes (testicles) to experience pain at some point in their lives. Pain can be short-term or long-term, severe or mild.

If you have pain in your testicles and do not know what is causing it, call your healthcare provider for advice. Although rare, some causes of testicular pain can cause permanent damage if not treated promptly.

In this article, let’s look at some of the common causes of testicular pain. Knowing what conditions can make your testicles hurt can help you determine whether a home remedy for testicular pain is appropriate or whether you should go to the nearest urgent care center or emergency department to be evaluated.

Injury or Trauma

The testicles, or male gonads, are surrounded by nerves. Because they are covered by only a thin layer of connective tissue and skin and are located in a vulnerable location, it is not uncommon for testicles to be injured. Therefore, being well-innervated to cause pain is a protective mechanism to alert you when there is a problem.

Injury to the testicles can result from direct contact or can occur after a strain injury. If you have persistent pain or swelling in the testicles after an injury, see your healthcare provider. Blood can leak into the tissue surrounding the testicle after an injury forming a hematocele or collection of blood.

Kidney Stones

Kidney stones are masses or crystals that settle out of the urine and vary in size. Kidney stones, even small ones, can stretch the tubes draining the kidneys and cause severe pain. Pain from kidney stones can radiate into the testicles.

Kidney stones can cause:

  • Flank or lower back pain
  • Nausea or vomiting
  • Blood in the urine
  • Pain with urination
  • Difficulty urinating
  • Urinary urgency
  • Fever or chills
  • Foul-smelling urine

Treatment for kidney stones varies based on their size and the symptoms they cause. Drinking plenty of fluids can help prevent kidney stones from developing.

Diabetic Neuropathy 

High blood sugar from diabetes can cause damage to nerves. A condition referred to as neuropathy. Nerve damage from diabetes can cause pain in your testicles.

Orchitis

Orchitis is an inflammation of the testicles. Inflammation is usually a result of a bacterial or viral infection. The mumps virus can cause orchitis in children and adults, especially those who have not had preventative vaccines. Adults who contract mumps more commonly develop complications than children.

Signs and symptoms of orchitis include:

  • Fever
  • Nausea
  • Vomiting
  • Fatigue
  • Testicular pain
  • Testicular swelling

It can be difficult to distinguish orchitis from testicular torsion, as both can cause severe pain. Severe pain in the testicles is a medical emergency.

If the pain is due to a bacterial infection causing orchitis, it can be treated with antibiotics. Viral infections are typically treated with antivirals and supportive care. An ultrasound can help determine whether the pain is due to testicular torsion, a condition that requires surgery.

Testicular Cancer

A painless lump on the testis may indicate testicular cancer. Testicular cancer is the most common cancer in men aged 15 to 35. Increased swelling or pressure in the testicles and scrotum can cause a dull ache or pain.

Signs and symptoms of testicular cancer include:

  • A painless lump on the testicle
  • A dull ache in the groin
  • Testicular swelling

Testicular cancer is very treatable. See your doctor if a testicular lump persists for more than a week or two, even if it is painless.

Erectile Dysfunction

Some causes of testicular pain can also cause erectile dysfunction. For example, sexually transmitted infections can cause epididymitis and erectile dysfunction. After identifying and treating the cause of testicular pain, some men may have persistent ED.

See your healthcare provider if you have ED. There are many treatment options for ED, including testosterone replacement therapy for men with low testosterone levels and the symptoms associated with low testosterone.

Testicular Torsion

Testicular torsion is a medical emergency that requires immediate treatment. The pain comes on suddenly and is severe. It occurs when the testicles twist on themselves, cutting off their blood supply. Although testicular torsion can occur at any age, more than half of the cases occur in 12-to-18-year-olds. Testicular torsion is rare in men older than age 35.

Signs and symptoms of testicular torsion include:

  • Sudden, severe testicular pain
  • Redness or purplish discoloration of the scrotum
  • Scrotal swelling
  • Nausea and vomiting

Testicular torsion is more common in the left testicle.

Inguinal Hernia

A hernia occurs when abdominal contents push through a weak spot in the muscle or tissue, creating a pouch. With an inguinal hernia, intestines or fat push through the lower abdominal muscles and bulge into the inguinal or groin area. The bulge may increase in size when you cough or lift something heavy.

You can be born with an inguinal hernia or develop one later in life. Inguinal hernias can develop slowly as the weak spot in the abdominal tissue gradually widens or suddenly after straining or lifting something heavy.

Inguinal hernias are typically not an emergency condition, but they can be painful, especially when abdominal pressure increases. However, if the herniated tissue becomes stuck or its blood supply is cut off, this is an incarcerated or strangulated hernia and is a medical emergency.

Epididymitis 

Epididymitis is inflammation of the epididymis, a coiled tube in the back of the testicles that stores and transports sperm. It is extremely common, with approximately 600,000 cases of epididymitis reported in the U.S. per year.

Signs and symptoms of epididymitis include:

  • Pain that gradually increases
  • Discharge
  • Pain with urination
  • Urinary frequency
  • Urinary urgency
  • Redness of the scrotal skin
  • Fever and chills

When the inflamed testicle or scrotum is physically lifted, pain typically decreases.

Epididymitis can have infectious or non-infectious causes. Sexually transmitted infections, such as chlamydia or gonorrhea, can cause epididymitis.

Varicocele 

Like varicose veins in the legs, a varicocele is a group of abnormally large veins near the testicles. Varicoceles usually cause a dull, aching pain that may improve when lying down. Because sperm development must take place within a very controlled temperature range, varicoceles can cause infertility and may require surgery for this reason.

How to Prevent Testicular Pain

It is important to have regular checkups to diagnose any medical conditions that may cause testicular pain as soon as possible. Early diagnosis and treatment can prevent problems such as erectile dysfunction later in life.

Injuries and trauma are common causes of testicular pain. It is essential to wear protective gear whenever you play contact sports.

When Should You See a Doctor?

The causes of testicular pain range from testicular torsion, which is a serious medical emergency that can cause irreversible damage to the testes, to muscle aches from strains.

Call your doctor if:

  • You don’t know the cause of your testicular pain.
  • You feel a lump on your testicles.
  • Or have symptoms that indicate an infection.

Seek emergency care if:

  • Pain onset is sudden and severe.
  • It causes nausea or vomiting.
  • The pain was caused by an injury.
  • It does not improve within an hour.
  • It causes discoloration of the scrotum.
  • It causes testicular swelling.
  • Pain gets worse instead of better.

Frequently Asked Questions

Who is most at risk for testicular pain?

Testicular pain can occur at any age, depending on the cause. Some causes of testicular pain, such as mumps, are more common in children, whereas testicular cancer is more common in younger adults.

Can Sexually Transmitted Diseases cause Testicular Pain?

Sexually transmitted diseases such as chlamydia and gonorrhea can cause testicular pain, along with discharge, urinary symptoms, and erectile dysfunction. The earlier sexually transmitted infections are treated, the less likely they are to cause persistent symptoms.

How Long Should Testicular Pain Last?

Pain can be acute and severe in cases like testicular torsion, or it can be long-term. How long testicular pain lasts depends on the cause of the pain.

Can Testicle Pain Go Away on its Own?

Testicular pain can go away on its own. However, because some causes of testicular pain require immediate surgery, you should contact your healthcare provider if you are not sure what is causing your pain, especially if the pain is acute or severe. Testicular torsion, inguinal hernias, testicular cancer, and varicocele may all need surgery.

Chronic testicular pain is called orchialgia. It is defined as testicular pain that lasts at least three months or more. It can be a constant pain or come and go. One testis or both can be affected. Pain can be from trauma, inflammation, or even a medical condition in another part of the body. Early diagnosis and treatment of testicular pain can prevent orchialgia and long-term complications like ED.

DISCLAIMER

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

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