Testicular discomfort is more than just an occasional annoyance or an unfortunate accident during sports—it can be a symptom of various underlying conditions that require attention. The testicles are very sensitive organs, which is why even minor issues can lead to significant discomfort. Participating in contact sports can increase the risk of testicular discomfort due to trauma or injury.
Whether you’re experiencing mild soreness or chronic pain that disrupts daily life, understanding the root causes and treatment options is essential for your health and peace of mind, as some causes of testicular discomfort require immediate medical attention and professional medical care.
What Is Testicular Pain?
Testicular pain refers to discomfort, soreness, or aching in one or both testicles. Pain in the testicles can have various causes and presentations, ranging from mild to severe, and may require prompt medical attention depending on the underlying condition. Scrotal pain is another term used to describe discomfort in the scrotal area. It may be acute (sudden and short-lived) or chronic (lasting more than three months). The pain can range from mild sensitivity to sharp, stabbing sensations, burning sensations (especially in cases of nerve-related pain), and it may radiate to the groin, lower abdomen, or even the back.
Common Symptoms Include:
- Dull ache or heaviness in the scrotum
- Sharp, localized pain
- Swelling or redness
- Pain during urination or ejaculation
- Fever or chills (indicating infection)
- Nausea or abdominal pain
Ignoring these signs could delay the diagnosis of potentially serious conditions. Let’s explore what might be causing them.
Common Causes of Testicle Pain
Understanding what causes testicular discomfort is the first step to finding relief. Several factors may contribute, and it is important to note that some causes of testicular pain require treatment to prevent complications. In younger men, certain causes, such as sexually transmitted infections, are more common. Additionally, prolonged sitting can aggravate chronic testicular discomfort, especially in cases related to nerve or pelvic floor issues:
- Injury or trauma
- Infection (such as epididymitis or orchitis)
- Testicular torsion (an emergency condition where the spermatic cord twists, cutting off the blood supply)
- Varicocele
- Hernia
- Kidney stones
1. Epididymitis
A leading cause of testicular pain, epididymitis is the inflammation of the epididymis, a coiled tube behind the testicle. Urinary tract infections are a common cause of epididymitis in older men. It is often caused by bacterial infections, including sexually transmitted infections (STIs) like chlamydia and gonorrhea, and can also result from a urinary tract infection.
2. Testicular Torsion (Medical Emergency)
This occurs when the spermatic cord twists, causing intense pain and cutting off blood flow to the testicle. The spermatic cord contains blood vessels, and when it twists, it blocks the blood supply. Testicular torsion must be treated quickly with urgent surgery to restore blood flow and prevent permanent damage. Emergency surgery is often required to save the testicle and prevent permanent loss. If you experience sudden, intense pain, you should go to the emergency room immediately. Delayed treatment can result in permanent damage or loss of the testicle.
3. Inguinal Hernia
An inguinal hernia occurs when part of the intestine protrudes through the abdominal wall into the groin or scrotum, causing discomfort or a noticeable bulge. This may worsen with physical activity or lifting.
4. Trauma or Injury
Direct trauma to the scrotum—whether from minor injuries or a direct blow, such as during sports or an accident—can result in bruising, inflammation, or internal bleeding.
5. Varicocele or Hydrocele
A varicocele is a condition involving enlarged veins within the scrotum, while a hydrocele is a fluid-filled sac around the testicle. Both conditions can cause scrotal swelling and may lead to a heavy or aching feeling in the testicles.
6. Post-Surgical or Nerve-Related Pain
Surgeries such as vasectomy, hernia repair, or even lower spine surgery may lead to nerve damage or persistent pain (called post-vasectomy pain syndrome or chronic orchialgia). Nerve-related pain can present as a burning sensation, hyperesthesia, or hypoesthesia, and may radiate to the scrotal skin. In some cases, pain may be triggered or worsened by sexual intercourse.
For patients with post-vasectomy pain syndrome who do not respond to conservative treatments, vasectomy reversal may be considered as a surgical option to help alleviate persistent pain.
Sexually Transmitted Infections (STIs) and Testicular Pain
A sexually transmitted infection (STI) is a common yet often overlooked cause of testicular discomfort. Chlamydia and gonorrhea can lead to epididymo-orchitis, where both the testicle and epididymis become inflamed. These infections require treatment to prevent long-term complications such as infertility or further damage. Symptoms may include:
- Burning during urination
- Discharge from the penis
- Painful ejaculation
- Scrotal tenderness or swelling
Early detection and treatment with antibiotics can resolve symptoms and prevent complications like infertility.
Chronic Testicular Pain: A Long-Term Concern
Chronic testicular pain, or chronic scrotal content pain, is persistent discomfort lasting longer than three months. It may stem from:
- Previous infections or injury
- Nerve hypersensitivity (neuropathy)
- Pelvic floor dysfunction
- Psychological stress or anxiety
A comprehensive physical examination, including assessment of the scrotum, genitals, and pelvic region, is essential for identifying the underlying cause of chronic testicular pain.
A thorough differential diagnosis is necessary to identify the specific cause of chronic testicular pain, distinguishing among conditions such as hydrocele, orchitis, testicular torsion, and tumors to ensure accurate diagnosis and appropriate treatment.
Treatment requires a multidisciplinary approach, often including:
- Physical therapy for pelvic floor health
- Scrotal elevation to reduce pain and swelling
- Medications for nerve pain
- Psychological support
- Nerve blocks
- Surgical options such as varicocelectomy, epididymectomy, vasovasostomy, microsurgical denervation, or orchiectomy if conservative measures fail
- Surgical intervention (e.g., microsurgical denervation of the spermatic cord or orchiectomy) in cases where less invasive treatments are unsuccessful
How Physical Therapy Can Help
A physical exam by a healthcare professional is an important first step in evaluating testicular pain and determining if physical therapy is appropriate.
Men often overlook the role of the pelvic floor muscles in managing testicular pain. Tension, weakness, or dysfunction in these muscles can cause referred pain to the scrotum or perineal area. The pelvic region also contains important structures such as the vas deferens, which may be involved in certain surgical procedures for testicular pain.
A pelvic health physical therapist can:
- Assess your core and pelvic floor function
- Guide you through targeted stretching and strengthening exercises
- Use manual therapy and biofeedback for neuromuscular re-education; some manual therapy techniques specifically aim to relieve pressure in the pelvic region
- Address posture, breathing mechanics, and movement dysfunctions
At-Home Strategies to Manage Testicular Pain
While professional help is essential, there are supportive steps you can take at home:
✅ Rest and Ice
For sudden injuries, apply an ice pack for 15–20 minutes several times a day to reduce inflammation.
✅ Supportive Underwear
Athletic or compression-style briefs help support the testicles and reduce strain.
✅ Pain Relief
Over-the-counter medications like ibuprofen can help manage inflammation. Always consult a doctor if symptoms persist.
✅ Pelvic Floor Relaxation Techniques
Try diaphragmatic breathing, gentle yoga, or mindfulness meditation to reduce pelvic tension and improve circulation.
When to Seek Medical Attention
Immediate medical help is required if you experience testicular pain, especially if you notice:
- Sudden, severe testicular pain
- Swelling with fever or nausea
- A noticeable lump or change in shape
- Pain following a groin injury
Seeking medical care is essential for sudden or severe symptoms, as prompt evaluation can prevent serious complications. In cases of severe pain, going to the emergency room may be necessary.
Don’t delay. Early diagnosis often leads to simpler and more effective treatment.
Final Thoughts: Taking Testicular Health Seriously
Testicular discomfort is common—but that doesn’t mean it should be ignored. While testicular cancer is a rare cause of testicular discomfort, it should still be considered and ruled out by a healthcare professional. Whether it’s caused by an infection, hernia, or pelvic floor dysfunction, there is help available.
At Pelvis NYC, our experts in men’s pelvic health specialize in treating the root causes of testicular and groin pain through personalized, evidence-based care.
👉 Ready to feel better?
Visit www.pelvis.nyc to book a consultation and take your first step toward lasting relief from testicular pain.
Stay proactive, stay informed, and remember—your health is worth talking about.
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