Testicular pain can be from a variety of conditions including epididymitis (inflammation of the epididymis), nerve damage, sexually transmitted infections (STIs), gangrene, swelling, hernia, kidney stones, inflammation, enlarged veins, fluid in the testicle, or a severe condition known as testicular torsion.
There may also be referred pain to the testis, which means there is pain that originates elsewhere, but is felt in the testis. This can occur if there is a pinched nerve in the back or in the groin area.
By far, one of the most common causes for pain in the scrotal contents is inflammatory change in the epididymis or testes. Inflammation can be due to a variety of causes, including urinary infection, viral illness elsewhere in the body, minor physical trauma, or reaction to medication. In many cases, the exact triggering cause of the inflammation cannot be identified.
Common causes of pain in the testis
Trauma or injury to the testicles can cause pain, but pain in the testicle is often the result of medical issues that will require treatment. These include:
- damage to the nerves of the scrotum caused by diabetic neuropathy
- epididymitis, or inflammation of the testicles, caused by the STI chlamydia
- gangrene, or the death of tissues, as a result of untreated testicular torsion or trauma
- a hydrocele, which is characterised by swelling of the scrotum
- an inguinal hernia
- kidney stones
- orchitis, or inflammation of the testicle
- a spermatocele, or fluid in the testicle
- an undescended testicle
- a varicocele, or a group of enlarged veins in the testicle
In some instances, pain in the testicle can be caused by a severe medical condition known as testicular torsion. In this condition, the testicle becomes twisted, cutting off blood supply to the testicle. This can cause damage to the tissue.
Testicular torsion is a medical emergency that must be treated quickly to prevent damage to the testicles. The condition occurs more frequently in males between the ages of 10 and 20.
Pain in the testicle is rarely caused by testicular cancer. Testicular cancer typically causes a lump on the testicles that’s often painless. Your doctor should evaluate any lump that forms on your testicles.
How is testicular pain treated?
It should be recognised that epididymitis is typically an inflammatory rather than infectious issue. Measures to address inflammation, including sitting in a warm bath for 20 minutes a day, scrotal support with athletic supporter or brief-style underwear, and anti-inflammation medication can provide relief.
In some cases, antibiotics may be used to address possible infection. It should be noted that if infection is not present, prolonged use of antibiotics is to be avoided to prevent potential overexposure to antibiotics.
At times, scrotal pain can be vexing to treat, and some men may notice it may take 2-4 months until symptoms subside. On some occasions pain can be persistent, and consultation with one of the pain management specialists may be carried out so that additional treatment can be attempted in an effort to achieve pain relief.