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Causes
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Treatment
Frequently Asked Questions
Orchialgia can affect one or both testicles, and the pain can range from mild and dull to severe and debilitating. The pain might even extend into the groin or abdomen.
This article explores different causes of testicle pain, including an overview of how they are diagnosed and treated. It also offers tips on how to relieve pain and prevent future episodes.
Verywell / Alexandra Gordon
Acute testicle pain is pain that occurs suddenly and severely. It has many possible causes, some of which may be immediately obvious (such as getting hit in the groin during sports).
Chronic testicular pain, or orchialgia, is an entirely different issue. This is defined as testicle pain that is either constant or comes and goes for three months or longer.
Chronic testicular pain can come from an infection, injured nerves, a pulled groin muscle, or other underlying conditions that directly or indirectly trigger pain in the testicles orscrotum(the pouch of skin that houses the testicles).
Pinpointing the exact cause of orchialgia can be difficult. Studies suggest that up to 50% of testicular pain cases areidiopathic(meaning of unknown origin). In cases like this, the pain may persist or resolve spontaneously on its own without treatment.
1:27Click Play to Learn How to Handle Testicular Pain Treatment at Home
1:27
Click Play to Learn How to Handle Testicular Pain Treatment at Home
There are seven common causes that a healthcare provider might consider when faced with a case of chronic testicular pain.
Epididymitis
Epididymitisis inflammation of a coiled tube at the back of the testicle called theepididymis. This causes swelling, pain, and, in severe cases, fever and chills.
Most of the time, epididymitis is the result of aurinary tract infection (UTI)orsexually transmitted infection (STI). It can also occur as a result of trauma or, less commonly, an autoimmune disease likelupusin which the immune system attacks healthy cells and tissues.
Testicular Trauma
Trauma to the testicle is usually mild. It often comes from a direct blow to the testicle or a straddle injury (such as can occur with a motorcycle accident).
Testicular injuries are very common in contact sports and with extreme cycling or horse riding. Most of the time, injuries like these don’t cause permanent damage.
Epididymal Hypertension
Masturbation with ejaculation can often help relieve the acute pain, although the condition usually resolves on its own without treatment.
Swollen Testicles
Inguinal Hernia
Testicle pain may occur when a part of your intestines squeezes into the scrotum with the testicles. This is a common condition known as aninguinal hernia.
An inguinal hernia may look like a groin bulge when a person coughs or lifts something heavy. In addition to pain, there may be a dragging sensation andswollen lymph nodesin the groin.
Post-Vasectomy Pain
After avasectomy—a surgical form of birth control that closes off the tubes that carry sperm—some people may experience swelling, firmness, and pain in the scrotum.
In some cases, it is because sperm has leaked into the testicle and causes a painful nodule known as a spermgranuloma.In other cases, a type of epididymitis known as congestive epididymitis can cause pain due to the blocked flow of sperm.
If a nerve becomes compressed and trapped after a vasectomy, this can lead to an uncommon condition known aspost-vasectomy pain syndrome.
Referred Pain
Not all pain in the testicle area starts there. You may havereferred pain, meaning nerve pain that originates somewhere else but is felt elsewhere (such as the testicle).
For example, you may have pain in your testicle because akidney stoneis stuck in the urinary tract or you have apinched nervein your lower back that radiates pain signals to the groin.
Testicular Torsion
Testicular torsionis an emergency that usually requires surgery. It happens when the cord that carries blood to the testicles twists.Testicular torsion causes sudden pain on one side of the testicles as well as swelling, nausea, and vomiting.
While testicular torsion is more common in infants and young boys, it can occur at any age.
When to Seek Medical AssistanceTesticular torsion is a medical emergency. If left untreated, the blockage of blood supply can cause testicular tissues to die (atrophy). Surgical repair must happen within six hours or the chances of losing the testicle are high.
When to Seek Medical Assistance
Testicular torsion is a medical emergency. If left untreated, the blockage of blood supply can cause testicular tissues to die (atrophy). Surgical repair must happen within six hours or the chances of losing the testicle are high.
Uncommon Causes
There are two rare causes of testicular pain that may be explored if an explanation cannot be found:
This photo contains content that some people may find graphic or disturbing.See PhotoDermNet /CC BY-NC-ND
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
DermNet /CC BY-NC-ND
Finding the cause of your testicle pain is the first step to getting well. Your healthcare provider will do a physical exam and recommend tests if you need them.
Physical Examination
During the physical exam, your healthcare provider will look at and feel your testicles. They may press on them to check for swelling, tenderness, skin changes, and lumps. The exam may include your abdomen and groin.
Labs and Tests
To check for infection, your healthcare provider will order a urine culture. You may also need a swab to screen for sexually transmitted infections such aschlamydiaandgonorrhea.
If your provider thinks cancer may be causing pain, you may need blood tests to check for alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH). These are substances calledtumor markersthat only make their way into the blood if cancer is present.
Imaging
One of the most common tests for testicular pain is anultrasound. This non-invasive device uses sound waves to create an image of the testicle that can detect injuries, abnormalities, nodules, and tumors. Acolor Doppler ultrasoundcan help detect blood circulation problems in cases of testicular torsion.
Other imaging tests may be ordered if more information is needed or in preparation for surgery:
The most effective treatment to relieve the pain will depend on what’s causing it. Here are a few options that might be part of your treatment plan.
Testicular Pain Treatment at Home
Cause and Treatment of Groin Pain
Medications
To help reduce pain, you can buy over-counter pain relievers like Tylenol (acetaminophen) ornonsteroidal anti-inflammatory drugs (NSAIDs)like Advil (ibuprofen) or Aleve (naproxen).
Prescription drugs may be prescribed to treat the underlying cause. This may involveantibioticsto treat certain STIs, UTIs, and other bacterial infections. The treatment of these infections will almost invariably relieve pain.
Nerve Block and Cord Denervation
A spermatic cordnerve blockmay be considered if the pain is chronic and does not respond to conservative treatment. With a nerve block, a specialist called aurologistinjects an anesthetic into the spermatic cord (a group of vessels and nerves that service the testicle and holds it in place).
In some cases, a urologist may cut the nerves to the testicle to stop the pain. This is called spermatic cord denervation, often done in an outpatient center and permanently relieves testicle pain in about 75% of men.
Surgery
To treat some conditions causing testicular pain, you may need surgery. Example include:
How to Prevent Testicle PainIf you have a history of testicle pain, it helps to wear a jockstrap when you are engaging in sports or other physical activities. Practice good hygiene anduse condomsto avoid getting an STI. It can also reduce the risk of UTIs if you engage in anal sex.
How to Prevent Testicle Pain
If you have a history of testicle pain, it helps to wear a jockstrap when you are engaging in sports or other physical activities. Practice good hygiene anduse condomsto avoid getting an STI. It can also reduce the risk of UTIs if you engage in anal sex.
Summary
Testicle pain can come from infection, injury, blocked fluids, or another health condition. Sometimes health professionals aren’t able to find an exact cause.
Treatment depends on the source of the problem. Antibiotics and anti-inflammatory medications are often part of the plan. Surgery may be necessary in rare cases. Sometimes, the nerve supply to the testicles may be cut to stop the pain.
Much of the time, simple at-home treatments can ease pain as you recover.
A Word From Verywell
In the vast majority of cases, testicle pain can be treated. Be open to discussing your concerns with your healthcare provider. And of course, seek immediate medical care for any sudden and severe testicle pain.
Frequently Asked QuestionsSometimes it can. In fact, in up to 50% of cases, the cause of testicular pain is unknown.With that said, you should seek immediate care if the pain is severe and causes nausea or vomiting or the testicle to ride up in the scrotum. These are signs of a medical emergency known as testicular torsion.Not typically. With testicular cancer, the tumor is most often painless. However, if the tumor is advanced, it can cause bleeding or block blood vessels or ducts, both of which can trigger pain.
Sometimes it can. In fact, in up to 50% of cases, the cause of testicular pain is unknown.With that said, you should seek immediate care if the pain is severe and causes nausea or vomiting or the testicle to ride up in the scrotum. These are signs of a medical emergency known as testicular torsion.
Not typically. With testicular cancer, the tumor is most often painless. However, if the tumor is advanced, it can cause bleeding or block blood vessels or ducts, both of which can trigger pain.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gordhan CG, Sadeghi-Nejad H.Scrotal pain: evaluation and management.Korean J Urol. 2015;56(1):3–11. doi:10.4111/kju.2015.56.1.3Tan WP, Levine LA.What can we do for chronic scrotal content pain?World J Mens Health.2017;35(3):146. doi:10.5534/wjmh.17047Michel V, Pilatz A, Hedger MP, Meinhardt A.Epididymitis: revelations at the convergence of clinical and basic sciences.Asian J Androl. 2015;17(5):756–763. doi:10.4103/1008-682X.155770Randhawa H, Blankstein U, Davies T.Scrotal trauma: a case report and review of the literature.Can Urol Assoc J. 2019;13(6 Suppl4):S67-S71. doi:10.5489/cuaj.5981Ayad BM, Van der Horst G, S Du Plessis S.Revisiting the relationship between the ejaculatory abstinence period and semen characteristics.Int J Fertil Steril. 2018;11(4). doi:10.22074/ijfs.2018.5192HerniaSurge Group.International guidelines for groin hernia management.Hernia. 2018;22(1):1–165. doi:10.1007/s10029-017-1668-xTan WP, Levine LA.An overview of the management of post-vasectomy pain syndrome.Asian J Androl. 2016;18(3):332–337. doi:10.4103/1008-682X.175090Patel AP.Anatomy and physiology of chronic scrotal pain.Transl Androl Urol. 2017;6(Suppl 1):S51–S56. doi:10.21037/tau.2017.05.32Laher A, Ragavan S, Mehta P, Adam A.Testicular torsion in the emergency room: a review of detection and management strategies.Open Access Emerg Med. 2020;12:237-246. doi:10.2147/OAEM.S236767National Cancer Institute.Testicular cancer screening: patient version.Chennamsetty A, Khourdaji I, Burks F, Killinger KA.Contemporary diagnosis and management of Fournier’s gangrene.Ther Adv Urol. 2015;7(4):203–215. doi:10.1177/1756287215584740Greenstein J, Babson V, Frisolone J, et al.Frequency of urinary tract infections, gonorrhea, and chlamydia in emergency department patients with acute scrotal pain.Cureus. 2021;13(7):e16347. doi:10.7759/cureus.16347Dieckmann KP, Simonsen-Richter H, Kulejewski M, et al.Serum tumour markers in testicular germ cell tumours: frequencies of elevated levels and extents of marker elevation are significantly associated with clinical parameters and with response to treatment.BioMed Research International. 2019;2019:1-22. doi:10.1155/2019/5030349Agrawal AM, Tripathi PS, Shankhwar A, Naveen C.Role of ultrasound with color Doppler in acute scrotum management.J Family Med Prim Care. 2014;3(4):409–412. doi:10.4103/2249-4863.148130Gordon J, Rifenburg RP.Spermatic cord anesthesia block: an old technique re-imaged.West J Emerg Med. 2016;17(6):811–813. doi:10.5811/westjem.2016.8.31017Chaudhari R, Sharma S, Khant S, Raval K.Microsurgical denervation of spermatic cord for chronic idiopathic orchialgia: long-term results from an institutional experience.World J Mens Health. 2019;37(1):78-84. doi:10.5534/wjmh.180035Additional ReadingAmerican Cancer Society.Tests for testicular cancer.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gordhan CG, Sadeghi-Nejad H.Scrotal pain: evaluation and management.Korean J Urol. 2015;56(1):3–11. doi:10.4111/kju.2015.56.1.3Tan WP, Levine LA.What can we do for chronic scrotal content pain?World J Mens Health.2017;35(3):146. doi:10.5534/wjmh.17047Michel V, Pilatz A, Hedger MP, Meinhardt A.Epididymitis: revelations at the convergence of clinical and basic sciences.Asian J Androl. 2015;17(5):756–763. doi:10.4103/1008-682X.155770Randhawa H, Blankstein U, Davies T.Scrotal trauma: a case report and review of the literature.Can Urol Assoc J. 2019;13(6 Suppl4):S67-S71. doi:10.5489/cuaj.5981Ayad BM, Van der Horst G, S Du Plessis S.Revisiting the relationship between the ejaculatory abstinence period and semen characteristics.Int J Fertil Steril. 2018;11(4). doi:10.22074/ijfs.2018.5192HerniaSurge Group.International guidelines for groin hernia management.Hernia. 2018;22(1):1–165. doi:10.1007/s10029-017-1668-xTan WP, Levine LA.An overview of the management of post-vasectomy pain syndrome.Asian J Androl. 2016;18(3):332–337. doi:10.4103/1008-682X.175090Patel AP.Anatomy and physiology of chronic scrotal pain.Transl Androl Urol. 2017;6(Suppl 1):S51–S56. doi:10.21037/tau.2017.05.32Laher A, Ragavan S, Mehta P, Adam A.Testicular torsion in the emergency room: a review of detection and management strategies.Open Access Emerg Med. 2020;12:237-246. doi:10.2147/OAEM.S236767National Cancer Institute.Testicular cancer screening: patient version.Chennamsetty A, Khourdaji I, Burks F, Killinger KA.Contemporary diagnosis and management of Fournier’s gangrene.Ther Adv Urol. 2015;7(4):203–215. doi:10.1177/1756287215584740Greenstein J, Babson V, Frisolone J, et al.Frequency of urinary tract infections, gonorrhea, and chlamydia in emergency department patients with acute scrotal pain.Cureus. 2021;13(7):e16347. doi:10.7759/cureus.16347Dieckmann KP, Simonsen-Richter H, Kulejewski M, et al.Serum tumour markers in testicular germ cell tumours: frequencies of elevated levels and extents of marker elevation are significantly associated with clinical parameters and with response to treatment.BioMed Research International. 2019;2019:1-22. doi:10.1155/2019/5030349Agrawal AM, Tripathi PS, Shankhwar A, Naveen C.Role of ultrasound with color Doppler in acute scrotum management.J Family Med Prim Care. 2014;3(4):409–412. doi:10.4103/2249-4863.148130Gordon J, Rifenburg RP.Spermatic cord anesthesia block: an old technique re-imaged.West J Emerg Med. 2016;17(6):811–813. doi:10.5811/westjem.2016.8.31017Chaudhari R, Sharma S, Khant S, Raval K.Microsurgical denervation of spermatic cord for chronic idiopathic orchialgia: long-term results from an institutional experience.World J Mens Health. 2019;37(1):78-84. doi:10.5534/wjmh.180035Additional ReadingAmerican Cancer Society.Tests for testicular cancer.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gordhan CG, Sadeghi-Nejad H.Scrotal pain: evaluation and management.Korean J Urol. 2015;56(1):3–11. doi:10.4111/kju.2015.56.1.3Tan WP, Levine LA.What can we do for chronic scrotal content pain?World J Mens Health.2017;35(3):146. doi:10.5534/wjmh.17047Michel V, Pilatz A, Hedger MP, Meinhardt A.Epididymitis: revelations at the convergence of clinical and basic sciences.Asian J Androl. 2015;17(5):756–763. doi:10.4103/1008-682X.155770Randhawa H, Blankstein U, Davies T.Scrotal trauma: a case report and review of the literature.Can Urol Assoc J. 2019;13(6 Suppl4):S67-S71. doi:10.5489/cuaj.5981Ayad BM, Van der Horst G, S Du Plessis S.Revisiting the relationship between the ejaculatory abstinence period and semen characteristics.Int J Fertil Steril. 2018;11(4). doi:10.22074/ijfs.2018.5192HerniaSurge Group.International guidelines for groin hernia management.Hernia. 2018;22(1):1–165. doi:10.1007/s10029-017-1668-xTan WP, Levine LA.An overview of the management of post-vasectomy pain syndrome.Asian J Androl. 2016;18(3):332–337. doi:10.4103/1008-682X.175090Patel AP.Anatomy and physiology of chronic scrotal pain.Transl Androl Urol. 2017;6(Suppl 1):S51–S56. doi:10.21037/tau.2017.05.32Laher A, Ragavan S, Mehta P, Adam A.Testicular torsion in the emergency room: a review of detection and management strategies.Open Access Emerg Med. 2020;12:237-246. doi:10.2147/OAEM.S236767National Cancer Institute.Testicular cancer screening: patient version.Chennamsetty A, Khourdaji I, Burks F, Killinger KA.Contemporary diagnosis and management of Fournier’s gangrene.Ther Adv Urol. 2015;7(4):203–215. doi:10.1177/1756287215584740Greenstein J, Babson V, Frisolone J, et al.Frequency of urinary tract infections, gonorrhea, and chlamydia in emergency department patients with acute scrotal pain.Cureus. 2021;13(7):e16347. doi:10.7759/cureus.16347Dieckmann KP, Simonsen-Richter H, Kulejewski M, et al.Serum tumour markers in testicular germ cell tumours: frequencies of elevated levels and extents of marker elevation are significantly associated with clinical parameters and with response to treatment.BioMed Research International. 2019;2019:1-22. doi:10.1155/2019/5030349Agrawal AM, Tripathi PS, Shankhwar A, Naveen C.Role of ultrasound with color Doppler in acute scrotum management.J Family Med Prim Care. 2014;3(4):409–412. doi:10.4103/2249-4863.148130Gordon J, Rifenburg RP.Spermatic cord anesthesia block: an old technique re-imaged.West J Emerg Med. 2016;17(6):811–813. doi:10.5811/westjem.2016.8.31017Chaudhari R, Sharma S, Khant S, Raval K.Microsurgical denervation of spermatic cord for chronic idiopathic orchialgia: long-term results from an institutional experience.World J Mens Health. 2019;37(1):78-84. doi:10.5534/wjmh.180035
Gordhan CG, Sadeghi-Nejad H.Scrotal pain: evaluation and management.Korean J Urol. 2015;56(1):3–11. doi:10.4111/kju.2015.56.1.3
Tan WP, Levine LA.What can we do for chronic scrotal content pain?World J Mens Health.2017;35(3):146. doi:10.5534/wjmh.17047
Michel V, Pilatz A, Hedger MP, Meinhardt A.Epididymitis: revelations at the convergence of clinical and basic sciences.Asian J Androl. 2015;17(5):756–763. doi:10.4103/1008-682X.155770
Randhawa H, Blankstein U, Davies T.Scrotal trauma: a case report and review of the literature.Can Urol Assoc J. 2019;13(6 Suppl4):S67-S71. doi:10.5489/cuaj.5981
Ayad BM, Van der Horst G, S Du Plessis S.Revisiting the relationship between the ejaculatory abstinence period and semen characteristics.Int J Fertil Steril. 2018;11(4). doi:10.22074/ijfs.2018.5192
HerniaSurge Group.International guidelines for groin hernia management.Hernia. 2018;22(1):1–165. doi:10.1007/s10029-017-1668-x
Tan WP, Levine LA.An overview of the management of post-vasectomy pain syndrome.Asian J Androl. 2016;18(3):332–337. doi:10.4103/1008-682X.175090
Patel AP.Anatomy and physiology of chronic scrotal pain.Transl Androl Urol. 2017;6(Suppl 1):S51–S56. doi:10.21037/tau.2017.05.32
Laher A, Ragavan S, Mehta P, Adam A.Testicular torsion in the emergency room: a review of detection and management strategies.Open Access Emerg Med. 2020;12:237-246. doi:10.2147/OAEM.S236767
National Cancer Institute.Testicular cancer screening: patient version.
Chennamsetty A, Khourdaji I, Burks F, Killinger KA.Contemporary diagnosis and management of Fournier’s gangrene.Ther Adv Urol. 2015;7(4):203–215. doi:10.1177/1756287215584740
Greenstein J, Babson V, Frisolone J, et al.Frequency of urinary tract infections, gonorrhea, and chlamydia in emergency department patients with acute scrotal pain.Cureus. 2021;13(7):e16347. doi:10.7759/cureus.16347
Dieckmann KP, Simonsen-Richter H, Kulejewski M, et al.Serum tumour markers in testicular germ cell tumours: frequencies of elevated levels and extents of marker elevation are significantly associated with clinical parameters and with response to treatment.BioMed Research International. 2019;2019:1-22. doi:10.1155/2019/5030349
Agrawal AM, Tripathi PS, Shankhwar A, Naveen C.Role of ultrasound with color Doppler in acute scrotum management.J Family Med Prim Care. 2014;3(4):409–412. doi:10.4103/2249-4863.148130
Gordon J, Rifenburg RP.Spermatic cord anesthesia block: an old technique re-imaged.West J Emerg Med. 2016;17(6):811–813. doi:10.5811/westjem.2016.8.31017
Chaudhari R, Sharma S, Khant S, Raval K.Microsurgical denervation of spermatic cord for chronic idiopathic orchialgia: long-term results from an institutional experience.World J Mens Health. 2019;37(1):78-84. doi:10.5534/wjmh.180035
American Cancer Society.Tests for testicular cancer.
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