Pain in the testicles in men: causes and treatment

Good day, dear readers! Perhaps pain in the testicles of men (orchialgia) occur at least once in life. They can affect one or both testicles and range from mild and dull pain to severe and debilitating. Moreover, pain can occur at any age: from adolescents to the elderly.

The causes of these pains can range from trauma to inflammation to more serious problems, and many cases of pain occur for unknown reasons. When they appear, you must contact the urologist.

The reasons

Periodic or persistent pain in the testicles, lasting for three months or more and disrupting normal daily life, known as  chronic orhialgia , is diagnosed after excluding other causes. Doctors often suspect that such pain is caused by pinching nerves, stretching the groin muscles, or spasms of the pelvic floor muscles, but this cannot be confirmed. Pain in the testicles in men is often observed for the following reasons.

Common causes


Epididymitis refers to inflammation of the epididymis (epididymis) – the duct located in the back of the testicles. Along with pain in the testicles, epididymitis causes swelling, and in severe, rare cases, fever and chills. In most cases, epididymitis occurs as a result of urinary tract infection or sexually transmitted diseases, but can also occur as a result of trauma or autoimmune disease.


Trauma to the testicle is usually mild, not causing serious damage and arising from a direct impact on the testicle or injury to the perineum.

Inguinal hernia

Pain in the testicles can occur when part of the intestine bulges into the scrotum (hernia). An inguinal hernia can be seen as a bulge in the groin when a man coughs or picks up something heavy.

After vasectomy

After vasectomy (sterilization), a man may notice hardness inside the epididymis (so-called congestive epididymitis) or a painful nodule, called a spermatogenic granuloma, which is a pathological formation in the testicular tissue due to the penetration of spermatozoa into it. Both conditions can cause discomfort. Pinching a nerve after a vasectomy can also cause testicular pain.

Torsion of testicles

Testicular torsion occurs as a result of twisting of the spermatic cord, which requires emergency surgery. This leads to the sudden appearance of unilateral, severe pain and swelling of the testicles, as well as nausea and vomiting. Although testicular torsion is more common in infants and puberty, it can occur at any age.

Rare causes

Fortunately, more serious causes of pain in the testicles are rare. However, it is important to listen to your body and, if necessary, seek the advice of a doctor.


Most testicular cancers do not cause pain, but rather are painless nodules or lumps. However, some rapidly growing tumors can bleed or interrupt the blood flow in the testicle, which can lead to testicular pain.

Gangrene feather

Fournier’s gangrene is a severe bacterial infection that starts on the abdominal wall, spreads to the scrotum and penis, and causes gangrene (tissue death). This is a rare but potentially life-threatening cause of scrotum pain and swelling.


Diagnosing the underlying cause of pain in the testicles is the first step to recovery and well-being. Your doctor will conduct a physical examination and, if necessary, will recommend to pass tests.

Physical examination

During a physical examination, the urologist will examine the testicles and then palpate them to check for swelling, tenderness, skin changes, or lumps or nodules. He can also perform an examination of the abdominal cavity and check for enlarged lymph nodes in the groin.

Analyzes and tests

To rule out an infection, such as epididymitis, your doctor will prescribe urine culture, as well as a urethral smear to detect sexually transmitted infections. If a tumor is suspected, blood tests for the presence of tumor markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) can be prescribed.

Medical Imaging Techniques

A visual test for examining pain in the testicles is ultrasound, which can reveal abnormalities such as testicular cancer. With testicular torsion, color Doppler ultrasound shows a decrease or absence of blood flow to the testicle.

Other diagnostic tests, such as computed tomography (CT) or magnetic resonance imaging (MRI), can be used to diagnose testicular cancer.

Differential diagnostics

Not all pain in the testicular area (testicle area) actually comes from the testicle. For example, the cause may be kidney stones or pinching of a nerve.

If your doctor suspects kidney stones, a urinalysis and / or computed tomography scan can be performed to evaluate your urinary tract system. In addition, imaging tools, often MRI of the spine and a thorough neurological examination can be used to diagnose a pinched nerve.


Depending on the cause of pain in the testicles, the urologist may recommend one of the methods of treatment.

Home procedures

Many causes of pain in the testicles can be treated or partially treated at home. For example, in addition to antibiotics, inflammation of the appendages (epididymitis) can be treated with nonsteroidal anti-inflammatory drugs, such as ibuprofen, to reduce pain, you can use suspensions to maintain the scrotum, cold compresses.

For men with unexplained orchialgia, the following options can bring relief. However, it must be borne in mind that it may take three months or more to improve the condition:

  • Rest :  do not lift heavy objects and do not exercise, requiring effort. Avoid exacerbation of muscle pain.
  • Heat:  using a heating pad or sitting in a hot bath can stimulate blood flow and soothe muscle pain.
  • Anti-inflammatory drugs:  Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can reduce pain.
  • Tight underwear:  wearing it helps restrain movement and pain.
  • Physical therapy : home exercises and stretching can help strengthen the muscles of the pelvic floor and relieve cramps.


In addition to anti-inflammatory drugs, antibiotics are used to treat infectious causes of pain in the testicles, such as epididymitis or Fournier’s gangrene.


For certain causes of pain in the testicles, surgery is required. For example, Fournier’s gangrene requires urgent surgical removal of infected and dying tissue, as well as sometimes reconstructive surgery. In addition, testicular torsion requires emergency surgery to quickly restore the blood supply to the affected testicle. Surgery is also the main treatment for almost all testicular cancer.

Nerve blocking and denervation of the spermatic cord

If the treatment of chronic orchialgia at home does not help, nerve block can be used. In this case, the urologist introduces anesthetic into the spermatic cord. If the painkiller does relieve pain, then the urologist may conclude that the cause of the pain is in the testicle.

If necessary, the urologist may suggest a procedure called denervation of the spermatic cord. This is done in the outpatient surgical center and relieves pain in the testicles for about 75 percent of men.

Dear readers, be sure that in the vast majority of cases, pain in the testicles in men can be treated. Be prepared to discuss your concerns with your doctor and, of course, contact him immediately for any sudden and severe pain in the testicles.

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