Some causes of testicle pain may include trauma, prolonged sitting, swelling, infection, spermatoceles, testicular torsion, and varicoceles. It may also be caused by pain elsewhere, such as the back.

Testicles are two egg-shaped reproductive organs located in the scrotum. They play a key role in producing sperm and male hormones, such as testosterone.

Pain in the testicles can be caused by minor injuries to the area. For instance, you may have some mild swelling and pain after sitting for too long with your legs crossed, or you may get hit in the groin area during sports.

Sometimes, testicle pain may not have an obvious physical cause, and it can result from medical issues that require treatment.

Keep reading to learn more about the causes of testicular pain, how it’s treated, and when to see a doctor.

Types of testicular pain

There are two main types of testicular pain, which may have different symptoms:

  • Nociceptive pain: This type of pain is usually associated with physical trauma, compression, or direct stimulus. It may cause an aching, dull pain and physical changes like swelling or shrinkage.
  • Neuropathic pain: This refers to nerve pain, which is usually caused by something outside the testicles, such as kidney stones or diabetic neuropathy. It may cause a burning sensation, numbness, itchiness, or an increase in your senses.

It’s important to speak with a healthcare professional if you experience any pain, swelling, or noticeable size changes in your testicles.

Orchitis is inflammation of the testicle, which can affect one or both at the same time. It may cause testicle pain, as well as fever, chills, and fatigue.

Orchitis is usually a symptom of an infection, the two most common being the viruses mumps and rubella. Bacterial and viral infections that affect the prostate and urinary tract can also cause orchitis.

Orchitis rarely occurs on its own.

How is it treated?

Treatment for orchitis depends on the underlying cause. For bacterial infections, a doctor may prescribe antibiotics. For viral infections, a doctor may recommend resting, applying a cold or hot compress, and taking over-the-counter (OTC) pain relievers like acetaminophen and ibuprofen.

Epididymitis occurs when the tube at the back of the testicles that carries sperm becomes inflamed. It’s usually caused by a sexually transmitted infection (STI) like chlamydia or gonorrhea, or a urinary tract infection (UTI).

Symptoms may include swelling, tenderness, pain, or a lump of fluid in one or both of your testicles.

How is it treated?

Epididymitis is usually treated with a course of antibiotics. It could take up to 3 months to fully recover.

A hydrocele is a collection of serous fluid that develops in the sac surrounding the testicles. It can be congenital (you’re born with it) or develop later in life.

In adults, hydrocele is usually acquired, which means it could be caused by:

How is it treated?

An acquired hydrocele will usually go away after the underlying cause is treated, such as infection. But if it’s big or doesn’t go away, then surgery is needed to remove it.

A spermatocele is a small, benign cyst of testicular fluid (usually sperm) that forms in the epididymis, which is the small tube behind your testes. It usually feels like a small lump on the top of your testicle.

These small cysts are relatively common. They don’t usually cause symptoms, but they can sometimes cause pain, swelling, and tenderness.

How is it treated?

If the spermatocele is small and doesn’t cause symptoms, you may not require treatment. However, if it’s painful or large, surgery to remove it is the best treatment plan.

A varicocele is when the veins inside your scrotum (known as pampiniform plexus veins) become enlarged, or swollen. It affects up to 15% of people with a scrotum, and 2% to 10% report testicle pain, too.

Varicocele is more common on the left side of your scrotum. More pressure is needed to pump blood up from this side of your scrotum back up to your heart. So, if the blood flows back, it may pool in the vein, causing varicocele.

How is it treated?

OTC pain relievers like acetaminophen and ibuprofen can help relieve testicle pain associated with varicocele. If the pain doesn’t get better, a doctor may recommend a type of surgery called varicocelectomy.

Epididymal hypertension, often referred to as “blue balls,” is testicle pain caused by having a prolonged erection without orgasm. This temporary pain may be due to the blood slowly draining from the testicles after an erection.

How is it treated?

Blue balls will usually get better after having an orgasm. If you don’t have an orgasm, it’ll usually go away on its own within a few hours of having an erection.

In some instances, testicle pain may be caused by testicular torsion, a severe medical condition in which the testicle becomes twisted, cutting off blood supply to the testicle. This can damage the tissue.

Testicular torsion happens when the testicles are not held to the scrotum because there are no tissues to support them. This can occur during sleep, rest, or exercise.

Testicular torsion causes sudden, severe pain and swelling. It affects 1 in 4,000 males under 25 years old.

How is it treated?

Testicular torsion is a medical emergency that must be treated quickly to prevent testicle damage. Permanent damage may start to occur after 6 hours of the testicles being twisted.

A doctor will untwist the testicles to improve blood flow and help relieve pain, but surgical repair will be needed to prevent future torsions. This involves untwisting the testicles and sewing them to the scrotum, a procedure called orchiopexy.

Sometimes, the testicles must be surgically removed if the torsion has been too long and caused severe, permanent damage.

Pain in the testicle is rarely caused by testicular cancer, but it could happen. It most commonly affects people ages 15 to 49 years.

Testicular cancer typically only affects one testicle. Symptoms may include:

  • a lump on one testicle, which is often painless
  • dull, aching pain of the testicles or scrotum
  • scrotum feeling heavy or hard
  • one testicle is swollen or larger than the other

How is it treated?

Treatment for testicular cancer will depend on many factors, such as the cancer stage and whether it has spread. The usual treatment is orchiectomy, which is when the testicle is removed.

Sometimes, testicle pain can be caused by other conditions that begin outside of the testicle. These conditions may affect the nerves or area around the testicles, causing pain.

Other causes of testicle pain may include:

Treatment will depend on the underlying cause, but could range from taking oral medications to getting surgery.

Connect with a healthcare professional if you experience any of the following symptoms:

  • a lump on your scrotum
  • testicles that are swollen, painful, or tender to touch
  • changes in the shape or size of your testicles, especially if only one is affected

To determine the underlying cause, a doctor will complete a physical exam of your abdomen, groin, and scrotum and ask you questions about your current health conditions and any other symptoms.

To provide an accurate diagnosis, they may need to order additional tests, including:

Get immediate medical attention

It’s important to get immediate medical attention if your testicular pain:

  • is severe or sudden
  • doesn’t go away after 1 hour
  • occurs along with nausea or vomiting

This can be a symptom of a health condition that requires medical treatment to prevent complications.

Pain that doesn’t require medical care may be treated at home by:

  • wearing an athletic supporter, or cup, to support the scrotum
  • applying ice to reduce swelling in the scrotum
  • taking warm baths
  • placing a rolled towel under your scrotum while lying down to support your testicles
  • taking OTC pain relievers like acetaminophen or ibuprofen to reduce pain

You can also take some measures to help prevent testicle pain or reduce the underlying causes. These include:

  • wearing an athletic supporter to prevent injury to the testicles
  • practicing safe sex, including using a condom, during intercourse
  • examining your testicles once per month to note changes or lumps
  • emptying your bladder completely when you urinate to help prevent UTIs

If you practice these steps and still experience testicular pain, speak with a healthcare professional.

In most cases, a doctor will need to untwist the testicles in testicular torsion and perform surgery to prevent the testicles from twisting again.

Ejaculating may give relief from epididymal hypertension (“blue balls”), but it might worsen pain caused by inflammatory conditions, such as varicocele, hydrocele, and spermatocele.

Some red flags include sudden, severe pain that doesn’t get better after 1 hour, as well as testicle swelling, changes in shape, and penile discharge.

Testicle pain may have several causes, ranging from sitting for too long and physical trauma to conditions like infections, varicocele, and testicular torsion.

Treatments will depend on the underlying cause. This may include home remedies and OTC pain relievers, as well as prescription medications and surgery.

A healthcare professional could help develop the best treatment plan for you.