What is testicular pain?
Testicular pain, pain in either the right or left testicle, or both, can have several causes. They can range from trauma to infection, but most often the cause is a mild trauma. It can occur in men or boys of any age. Most cases of testicular pain are non-urgent and the pain should go away within a few days.
Because the testicles are so sensitive, even mild testicular pain can have an impact on how a boy or man moves, sits or sleeps.
However, severe testicular pain could be caused by an infection, or a testicle could become twisted, a condition called testicular torsion. If this is not treated quickly, the testicle can lose its blood supply and the tissue can die. Severe or sudden testicular pain, particularly if accompanied with a fever, is a medical emergency. In this case, seek immediate medical care (call 911).
What other symptoms might occur with testicular pain?
Men and boys with testicular pain can experience sharp acute pain or a dull ache. The type of pain depends on the cause. For example, testicular torsion (twisting) causes sudden, severe pain, as can direct trauma to the area. On the other hand, an infection called epididymitis usually causes a gradual build-up of pain starting as a dull ache and progressing to severe. Other symptoms that can accompany testicular pain include:
- A feeling of fullness or heaviness in the scrotum
- A lump in the scrotum
- Scrotal or testicle swelling
- A feeling of warmth on or around the scrotum
- Redness on or around the scrotum
- Pain in the groin or lower abdomen
- One testicle feels higher than the other
- Discharge from the penis
- Burning while urinating
Contact your doctor as soon as possible if you experience any of these symptoms along with testicular pain. Also, call your doctor right away if you were exposed to someone who had mumps, as these symptoms could indicate mumps infection.
Symptoms that might indicate a serious condition
In some cases, testicular pain may occur with other symptoms that could be a sign of a serious condition that requires immediate medical care:
- Sudden testicular pain
- Severe testicular pain
- Continued testicular pain an hour after injury or trauma to the scrotal area
- Swelling an hour after an injury or trauma to the scrotal area
- Nausea and vomiting
What causes testicular pain?
The most common cause of testicular pain is an injury to the scrotum. Other causes include:
- Infections. When the infection is in the sperm duct (epididymis), it is called epididymitis. When it is in the testicles, it is called orchitis. Other infections, like prostatitis and urinary tract infections, can also cause testicular pain.
- Varicoceles. Enlarged veins in the scrotum, similar to varicose veins in the legs
- Spermatocele. A cyst in the epididymis
- Hydrocele. Fluid around the testicle
- Vasectomy recovery. While rare, some men experience testicular pain after a vasectomy. This is called post-vasectomy pain syndrome.
- Testicular torsion. A medical emergency where the testicle wraps itself around the spermatic cord and cuts of the circulation to the testicle. It most often occurs spontaneously while walking, running, sitting or even sleeping.
Testicular cancer rarely causes testicular pain; however, if you find a lump, see a doctor to have it examined.
Other causes of testicular pain
Testicular pain can also result from complications of infections and other conditions, such as:
- Diabetic neuropathy
Reducing your risk of testicular pain
Not all causes of testicular pain can be prevented; however, regular testicular and scrotal examinations help men determine what feels normal. They can then detect any changes in the testicles if any occur.
To prevent trauma to the testicles, men should wear protective equipment when appropriate.
When should you see a doctor for testicular pain?
Most mild testicular pain can be managed at home. However, some causes of testicular pain require medical treatment to prevent complications, so you should see a doctor as soon as possible if:
- The pain is mild but does not go away after a few days.
- The pain is severe enough to affect how you get through the day.
- There is a lump or swelling in the scrotum.
- The scrotum is warm to touch and/or reddened.
- You have a fever.
- You have been in contact with someone who had mumps.
Go to your nearest emergency room for testicular pain if it is:
- Sudden and severe
- Still present an hour after injury or trauma to the scrotal area, particularly if there is swelling as well
- Causing nausea and vomiting
How is the cause of testicular pain diagnosed?
To diagnose why you have testicular pain, your doctor will ask for a medical and sexual history, and questions, such as:
- When did the pain start?
- Is there an identifiable cause (like a trauma)?
- Are there other symptoms aside from the pain?
- Does the pain move, as in to the lower back?
- Have you been exposed to mumps or any sexually transmitted diseases?
- Does anything make the pain go away or lessen?
After a physical exam in which the doctor examines the scrotum and feels the testicles, you may be sent for tests including:
- Ultrasound or other imaging tests to view conditions inside the testicles
- Urine tests for urinary tract infections
- Urethral swab for sexually transmitted infections
It is not always possible to diagnose an underlying cause or condition for testicular pain. Your doctor may refer you to a urologist for further testing if needed.
What are the treatments for testicular pain?
Treatment for testicular pain depends on the cause. If the pain is mild and does not have other symptoms, treatment usually involves over-the-counter pain relievers, ice, and support with an athletic supporter. Some men also find relief by taking warm baths and placing a rolled-up towel under their scrotum while lying down.
If medical treatment is warranted, it could include:
- Antibiotics for infection
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), to reduce swelling
- Surgery if the testicles are twisted, a varicocele needs to be corrected, or fluid needs to be removed
What are the potential complications of testicular pain?
There are few complications related to mild testicular pain. Untreated severe pain could result in complications depending on the cause:
- Untreated infections could lead to sepsis.
- Untreated twisted testicles could lead to tissue death
Other complications include:
- Loss of a testicle