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Testicle pain: what could it be?

Testicle pain or discomfort can be a symptom of a minor injury or health issue, but it may also be a sign of something more serious. What are the possible causes of your pain? And how do you know when to get it checked out by a professional?

What causes testicle pain?

The sensitivity of testicles means that some testicle pain is an annoying but inevitable part of life. Vincent Wolverson, CEO of testicular cancer charity It's On The Ball, says:

"You may experience an ache in the testicles if they are knocked - for example, while playing sport or cycling - and sometimes after sex or ejaculating."

However, sometimes testicle pain is a sign that something is wrong. We take a look at the various causes of testicle pain and ask the experts their advice on seeking medical attention.

For Wolverson, one of the most important things you can do for your health is to not shy away from talking about your testicles: "If in doubt, get them checked out - don't die of embarrassment."

The more serious causes of testicle pain

Testicular cancer

Pain in the testicle can be a sign of testicular cancer. However, testicle pain by itself is not usually a symptom. "Testicular cancer presents in a number of ways, and these may not always be painful," explains Wolverson. He says that the most common symptom is a lump felt on the testicle which may be painless or painful to touch. Other symptoms include a heaviness or dragging sensation, a swelling of the testicle, or a feeling of hardness. A dull ache or pain and discomfort in the groin area or abdominal pain can also be a symptom of testicular cancer - if you experience any of these he says you should seek medical advice.

To spot testicular cancer in its early stages, Giulia Guerrini, lead pharmacist of digital pharmacy Medino, recommends you regularly check for any lumps or swelling on your testicles, as well as any changes in shape or texture.

"Don't self-diagnose the cause of your pain and, instead, you should contact your GP." says Guerrini

Testicular torsion

According to Guerrini, the most severe testicle pain is often caused by testicular torsion - when a testicle rotates itself and cuts off the cord which brings blood into the scrotum.

It's not clear why some men get testicular torsion while others don't, although it's likely to do with an inherited trait that allows some men's testicles to rotate more freely inside the scrotum. Rotation of the testicle tends to occur after a minor injury to the testicles, vigorous activity, or during sleep.

"The lack of blood flow causes sudden pain as well as swelling, and it can lead to the loss of the testicle if not treated quickly by a medical professional." For this reason, you should go to the emergency department immediately if you have any intense testicular pain.

This serious condition is rare. It's thought to happen to around 1 in 4,000 men under 25 years old, which is the most common age group1.

How to check yourself for testicular cancer

Checking your testicles can be an easy way to make sure there aren't any unusual lumps and bumps...

Other possible causes

There are a number of less serious possibilities as well. These include:

  • An injury - for example, forceful impact during sports.
  • Epididymitis - an infection of the duct connected to your testicles.
  • A non-cancerous cyst - a harmless build-up of fluid in that area.
  • Varicocele - swollen, enlarged veins in the testicles.

These are some of the most common causes, but there are many more possibilities. They all need to be checked out by a doctor in case you need medication, scans or further follow ups to ensure there isn't anything sinister behind the symptoms. Here we address some of the most frequently asked questions.

Can a pulled groin cause testicle pain?

Your groin is the area where the lowest part of your stomach meets your upper thighs. A pulled muscle, ligament, or tendon in this area is usually the result of an upper leg injury, commonly caused by sports that involve a lot of running and twisting, like football and hockey. As your testicles are located nearby, this can sometimes cause inflammation in the testicles and testicle pain2.

Can a hernia cause testicle pain?

It's possible that your testicle pain relates to a health problem somewhere else in your body. This is the case with hernias, for example when a part of your small intestine pushes into the scrotum where your testicles live. This pressure can cause testicular pain, scrotal pain, and swelling3.

Can kidney stones cause testicle pain?

Kidney stones can't pass through the testicles, but occasionally the type of pain they cause is felt away from their direct path of travel. As well as testicle pain, kidney stones have been reported to trigger pain all the way down a person's back4.

Can UTIs cause testicle pain?

Urinary tract infections (UTIs) travel the same path as kidney stones; through your kidneys, bladder, ureters (the tubes connecting your kidneys and bladder) or urethra (the tube through which urine from your bladder leaves your body). This means that you can't get a UTI in your testicles, but sometimes the pain you get when you urinate extends to the testicles.

Can back pain cause testicle pain?

Back pain can't directly cause testicle pain, but sometimes nerves are irritated or people experience these pains together indicating an underlying health issue. For example, a UTI can lead to testicle pain when you urinate and lower back when the lining of your bladder or urethra becomes irritated5.

Another example is epididymitis, where the swelling of the duct that transports sperm can cause pain in the testicles but also reach beyond this region to your lower back and sides.

When should you go to the doctor for testicle pain?

Given that there are many possible causes of testicle pain ranging in severity, it can be hard to know when to see a doctor.

Medical emergency - visit A&E if:

  • Testicle pain is severe and sudden.
  • The pain is accompanied with tummy pain, feeling sick, or being sick
  • if the pain persists when you're resting.
  • If you continue to experience pain that lasts for longer than an hour.

Medical attention - visit your GP surgery if:

  • You're worried about a dull ache in one or both testicles.
  • One or both testicles have a lump, appear swollen, or look different in shape.
  • They feel different than normal.

If you're not sure what to do and live in the UK, call the NHS non-emergency hotline for advice on 111.

Further reading

  1. Urology Care Foundation: What is testicular torsion?
  2. Penn Medicine: Groin pain.
  3. Urology Care Foundation: What are hydroceles and inguinal hernias?
  4. National Kidney Federation: Pain in kidney or urine diseases.
  5. Urology Care Foundation: What is a urinary tract infection (UTI) in adults?
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