Testicular Pain: 8 Causes And When To See A Doctor

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Medical News TodaySubscribe8 possible causes of testicular pain, what to know and when to see a doctor

Medically reviewed by Matt Coward, MD, FACS — Written by Hana Ames — Updated on October 18, 2023

Epididymitis
Hernias
Kidney stones
Orchitis
Torsion
Tumor
Trauma
Varicoceles
Pediatric testicular pain
Contacting a doctor
Summary

Testicular pain can have several causes, including a traumatic injury, kidney stones, a hernia, an infection, and various other health conditions. Some are minor, but others need urgent medical attention.

Testicular pain may be due to an injury or condition that has started in the testicles or groin, but in many cases, it has causes elsewhere in the body. A person may also experience testicular pain for reasons such as hernias, pinched nerves, or gastrointestinal issues.

Keep reading to learn about the possible causes of testicular pain and when to see a doctor.

Epididymitis

View from below of a stone statue with testicles obscured by a scribble. — jessekarjalainen/Getty Images

Epididymitis is an infection of the epididymis, which is the organ where sperm matures before exiting the body.

Symptoms of epididymitis can include:

pain that gradually increases
a scrotum that feels hot to the touch
swelling

Sexually transmitted infections, such as chlamydia and gonorrhea, can cause epididymitis. Urinary tract infections can also lead to epididymitis.

Learn more about epididymitis.

Hernias

Hernias occur when tissue pushes through a weak part of the abdominal muscles. An inguinal hernia is one type of hernia that can push into the scrotum, causing testicular pain and swelling.

Doctors may be able to reduce an inguinal hernia or push it back into place. However, a hernia will almost always require surgery (hernia repair).

Learn more about hernias.

Kidney stones

Kidney stones can cause pain that radiates to the testicles. Doctors call this referred pain, which occurs beyond the area that is causing the problem.

Other symptoms that doctors may associate with kidney stones include:

blood-tinged urine
burning when urinating
nausea
pain at the top of the penis
sharp, cramping pain that may radiate from the back to the groin
urinating frequently
vomiting

Doctors may advise waiting for the kidney stones to pass. However, if a stone does not pass after some time or a person experiences symptoms of an infection, such as a fever or discharge, they should seek treatment as soon as possible.

Learn more about kidney stones.

Men’s health resources

For more research-backed information and resources, visit our dedicated men’s health hub.

Orchitis

Orchitis is an infection and inflammation of the testicles. Untreated epididymitis can lead to orchitis.

Symptoms of orchitis can include:

fatigue
fever
nausea
testicular pain
swelling in one or both testicles
vomiting

People should seek immediate treatment for orchitis. Sometimes, the pain can be so severe that it is similar to testicular torsion, which is a medical emergency.

Learn more about orchitis.

Testicular torsion

Testicular torsion is a serious medical condition that occurs when the spermatic cord twists, like a candy cane, and cuts off the blood supply to the testicle. The spermatic cord is the ‘stalk’ of the testicles that contains blood vessels and vas deferens. The vas deferens is the duct that transports sperm from the epididymis to the ejaculatory ducts before ejaculation.

Symptoms that doctors associate with testicular torsion include:

nausea
redness or darkening of the scrotum
sudden, severe pain that occurs on one side of the scrotum
swelling in the scrotum
vomiting

The pain from testicular torsion is sometimes gradual. Some people with this condition experience pain that slowly worsens over several days.

According to the American Urological Association, testicular torsion typically occurs on the left side more than the right.

Learn more about testicular torsion.

Testicular tumor

A testicular tumor can cause pain and swelling in the testicular area. Other symptoms may include:

a dull ache in the groin
a lump in the testicle
testicular swelling

Symptoms of a testicular tumor can resemble several other conditions that affect males, such as inguinal hernias and epididymitis. A doctor can help to diagnose the tumor or any underlying condition.

Read about testicular cancer.

Trauma

A blow to the testicles can cause bruising, pain, and swelling. A testicle can also rupture or develop a hematocele. A hematocele occurs when blood pools around the testicle and presses on it, affecting blood flow.

If a person has experienced a blow to the testicles and has pain and swelling, it is best to seek urgent medical attention.

Varicoceles

Varicoceles are abnormally large, dilated veins in the testicles. Sometimes, varicoceles do not cause symptoms.

When they do, a person may notice testicular pain that worsens with physical activity or over the day. Varicoceles may also affect a person’s fertility.

Doctors do not know what causes varicoceles, but they can usually treat them with surgery.

Most varicoceles are asymptomatic, and doctors often find them incidentally. If doctors do find them, they do not usually require treatment because the testicular pain usually results from something else.

Learn more about varioceles.

Pediatric testicular pain

Children may experience pain in the testicles from trauma, often from sports or playing rough. However, testicular pain in teenagers and younger children can have the same causes as in adults.

People should seek medical attention if their child complains of testicular pain. It can sometimes be a medical emergency that requires immediate treatment. It is better to discuss this with a healthcare professional and be cautious than to risk serious harm.

Additional causes and treatment

Additional causes of testicle pain may include:

Diabetic neuropathy: This nerve damage due to diabetes can also cause pain in the testicles. Managing the underlying diabetes can resolve the problem.
Hydrocele: This is a fluid buildup that causes swelling of the scrotum. They typically affect babies but can impact males of any age. While they are generally painless, there may be pain from the swelling. In infants, the hydrocele will typically resolve on its own. In adults, surgery may be necessary.
Idiopathic testicular pain: This is where the testicular pain is due to an unknown cause. Treatment may include pain management while doctors investigate further.
Mumps: Most people with mumps recover quickly. However, males who get mumps after puberty can develop complications such as inflammation of the testicles.
Prostatitis: This is an infection or inflammation of the prostate. Treatment varies depending on the individual but can include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or warm baths.
Scrotal masses: The treatment will vary depending on the cause of the mass. Some causes of scrotal masses include epididymitis and cancer.
Spermatocele: This is a fluid buildup in the testicle, also known as a spermatic cyst. These may not require treatment, but medications can ease the pain if they become too large.
Urinary tract infection: This is where bacteria enter the urinary tract, which includes the urethra, bladder, and kidneys. One symptom of the infection may be testicular pain. Sometimes, the infection may clear by itself, but other times, it may need antibiotics.
Back pain: Testicular pain may result from pinched nerves from slipped or herniated discs.
Gastrointestinal issues: One example of a gastrointestinal issue that can cause testicular pain is diverticulitis. Diverticulitis is an inflammation of pouches in the intestines.

When to contact a doctor

It is best to see a doctor if any of the following symptoms accompany testicular pain:

discoloration of the testicles
nausea
unusual, bloody, or cloudy discharge from the penis
testicular swelling
vomiting
pain that gets worse over time

Anyone with symptoms of testicular torsion should seek emergency medical attention. Without treatment, any condition that affects blood flow could result in loss of the testicle or surrounding parts.

Summary

If a person experiences swelling or pain in one or both testicles, it is best to see a doctor. They should seek immediate medical attention if the pain causes nausea and vomiting.

In cases of testicular torsion, the sooner a person seeks help, the more likely they can receive prompt attention for restoring blood flow.

Medical treatments are available for most causes of testicular pain.

Alsaikhan, B. et al. (2016). Epidemiology of varicocele. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770482/
Cho, C.-L. et al. (2016). Novel insights into the pathophysiology of varicocele and its association with reactive oxygen species and sperm DNA fragmentation. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770484/
Do I have testicular cancer? (2016). https://www.cancer.org/content/dam/CRC/PDF/Public/6072.00.pdf
Leslie SW, et al. (2023). Chronic testicular pain and orchalgia. https://www.ncbi.nlm.nih.gov/books/NBK482481/
Rotker K, et al. (2016). Recurrent varicocele. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4770491/
Scali JT, et al.(2021). Intraperitoneal abscess from perforated diverticulitis with fistualization to extraperitoneal abscess into the scrotum: A case report. https://afju.springeropen.com/articles/10.1186/s12301-021-00251-w
Wald, M. (2018). Testicular pain. https://uihc.org/health-topics/testicular-pain
What are hydroceles and inguinal hernias? (n.d.). http://www.urologyhealth.org/urologic-conditions/hydroceles-and-inguinal-hernia/printable-version
What is testicular torsion? (n.d.). https://www.urologyhealth.org/urologic-conditions/testicular-torsion

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Medically reviewed by Matt Coward, MD, FACS — Written by Hana Ames — Updated on October 18, 2023

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