Pain in one testicle can be rare and serious if not treated promptly. The pain can reside in either the right or left testicle and be associated with testicular swelling, lower abdomen pain, and burning when urinating. Sharp pain in one testicle can be caused by testicular torsion, an injury to the groin, a bacterial infection, or prostatitis. Read below for more causes and treatment options.
8 most common causes
Pain in one testicle symptoms explained
Experiencing an injury to or inflammation in just one testicle is not necessarily unusual, but you should get treatment promptly. Most related conditions heal readily, although some can cause permanent damage and loss of fertility if treatment does not begin right away. Inflammation of one testicle is also called unilateral (one-sided) testicular pain or unilateral orchitis.
Common characteristics of pain in one testicle
If you're experiencing pain in one testicle, it will likely present with the following.
- Sudden, severe pain in one testicle
- Dull pain that may radiate from, or into, your lower abdomen
- Swelling, redness, and soreness of your scrotum and testicle
- Unusual positioning: The testicle may seem to be hanging or lying in an unusual position or placed higher than normal within your scrotum.
Common accompanying symptoms of pain in one testicle
If you're experiencing pain in one testicle, it's also likely to experience:
- Unusual discharge from your penis
- Burning with urination
- Frequency of urination
- Blood in your urine
- Cloudy urine
- Feeling of itching or irritation within your penis
- Fever and chills
- Nausea and vomiting
- Lightheadedness
Who is most often affected?
It's possible for any male to be affected by pain in one testicle, especially those having unprotected anal or vaginal sex, men who are sexually active in general, teenage boys or young men, as well as male infants less than one year of age.
When is pain in one testicle most likely to occur?
Pain is more likely just before and during sexual activity, after ejaculation, and during and/or after exercise. You may experience pain when awake, asleep, standing, sitting, or moving.
Is pain in one testicle serious?
The severity of pain in one testicle depends on the cause.
- Not serious: Mild pain and swelling that may occur after something like a long horseback or bicycle ride, and presents no other symptoms, is probably not serious.
- Moderately serious: Testicular pain along with burning on urination is most likely due to a urinary tract infection or a sexually transmitted disease.
- Serious: Sudden, severe pain in one testicle is very serious and must be treated immediately.
What can cause testicle pain?
Many conditions can have pain in one testicle as a symptom. The following details may help you better understand your symptoms and if and when you need to see a physician.
Most common cause types
The most common causes of pain in one testicle include the following.
- Torsion: This condition is when your spermatic cord (the testicular blood supply) is twisted. Testicular torsion occurs most often on the left side and rarely affects both sides at once.
- Testicular appendage torsion: This condition involves the twisting of a small piece of vestigial tissue that lies across the top of your testicle, inside your scrotum. The symptoms are similar to actual torsion but not as severe. One side of your testicle will be sore to the touch with a small, hard lump at the top. This condition rarely happens after age 18, and usually resolves on its own.
- Trauma/injury: A trauma or injury can occur due to accident, sports injury, riding a horse or bicycle, hematoma, contusion, or rupture of the testicle and result in torsion.
Less common cause types
Less common causes of pain in one testicle includes the following.
- Bacterial infections: These are usually from sexually transmitted diseases, or from infection with E. coli bacteria. E. coli is a normal inhabitant of your colon and is found in feces.
- Prostatitis: This condition is inflammation of your prostate and usually spreads to other parts of the urinary and reproductive system, causing pain and discomfort throughout.
- Scarring of the epididymis: Chronic inflammation can damage the epididymis, the long, coiled tube that carries semen. Inflammation is likely to occur from prostatitis or sexually transmitted disease.
- Viral infections: Mumps, chickenpox, and other viral infections can affect the testicles.
- Kidney stones: If a stone travels down the ureter, it can cause severe pain in the testicle.
- Testicular abscess: This is a pocket of infection, usually from an injury with a break in the skin.
Rare and unusual pain in one testicle causes
The following, although possible, are the least likely to cause pain in one testicle.
- Torsion that has no apparent cause: However, torsion may follow an injury to the testicle.
- Congenital abnormality: It's possible to be born with a condition that causes the testicles to move freely within the scrotum, instead of being anchored down. This condition can lead to torsion.
- Inguinal hernia: An inguinal hernia is when a loop of small intestine protrudes into the scrotum.
- Post-vasectomy pain: This pain is from granulated or coarsely healing tissue that may form at the site of the surgery and may occur months or years later.
- Sexual arousal without release: This occurrence can cause pain in one or both testicles, particularly in young men.
- Tumor within the scrotum: Pain and swelling will be gradual in onset.
This list does not constitute medical advice and may not accurately represent what you have.
Intermittent testicular torsion
Intermittent testicular torsion is also called ITT or chronic testicular torsion. Torsion refers to an abnormal twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.
In intermittent cases, the testicle becomes untwisted on its own and the symptoms spontaneously resolve. The condition nearly always returns, however, and may continue to come and go.
The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.
Symptoms include sudden, severe groin and testicular pain with nausea and vomiting, followed by spontaneous relief of symptoms even without treatment.
Eventually, testicular torsion can result in loss of circulation followed by tissue death and loss of the testicle. Any type of testicular torsion is a medical emergency. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and sometimes ultrasound.
Treatment involves emergency surgery to untwist the spermatic cord and anchor the testicle in its proper place within the scrotum.
Rarity: Rare
Top Symptoms: nausea, testicle pain that comes and goes, vomiting, pain in one testicle, testicular swelling
Symptoms that always occur with intermittent testicular torsion: testicle pain that comes and goes
Urgency: Primary care doctor
Urinary tract infection
A urinary tract infection, or UTI, can involve any or all parts of the urinary system but most often affects the bladder and urethra.
Bacteria from the gastrointestinal tract – especially Escherichia coli (E. coli) – are the most common cause of UTIs. These bacteria spread from the anus to the urethra. Sexual activity can do this, but a UTI is not considered a sexually transmitted disease.
Women are more at risk for UTI than men. Due to female anatomy, the urethral opening is a short distance from the anus. Anyone who uses catheters to urinate is also prone to UTIs.
Common symptoms of less-serious UTIs include lower abdominal discomfort and pressure; burning or discomfort on urination; and cloudy or discolored urine.
Left untreated, the infection could spread to the kidneys and cause a medical emergency.
Diagnosis is made by having the patient describe the symptoms and by testing a urine sample for bacteria.
UTIs are caused by bacteria and so can be treated with antibiotics.
Prevention involves good hygiene and drinking plenty of water.
Testicular torsion
Testicular torsion is also called ATT or acute testicular infarction. It is a twisting of the spermatic cord, which runs from each testicle up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts.
The cause is believed to be a congenital abnormality that leaves the testicle insufficiently anchored within the scrotum.
Most susceptible are infant boys and boys just reaching puberty. Torsion may occur in older boys after an injury and/or an athletic workout.
Symptoms include sudden, severe, one-sided testicular pain and swelling, with nausea and vomiting.
Acute testicular torsion is a medical emergency. If not corrected immediately, the loss of blood flow can lead to infertility and loss of the testicle. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through physical examination and sometimes ultrasound.
Treatment involves first attempting to manually rotate the testicle back into place. If unsuccessful, surgery will be done to either correct the torsion or to remove the testicle if the damage is not reversible.
Painful bladder syndrome (interstitial cystitis)
Painful bladder syndrome, also called interstitial cystitis or IC, is a chronic condition of pain and discomfort in the urinary system.
The cause is unknown. It may be an autoimmune disorder and is often found with fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, or vulvodynia (pain in the outer female organs.) Some researchers feel the condition may be linked to a history of abuse.
Painful bladder syndrome is more common in women than in men, but can happen to anyone.
Symptoms vary and may include pressure and discomfort in the lower abdomen; pain during sexual intercourse; bladder pain; and a frequent urge to urinate.
A medical provider should be seen for these symptoms, because painful bladder syndrome can interfere with quality of life and lead to depression.
Diagnosis is made through patient history; physical examination; blood and urine tests; and sometimes cystoscopy. Women may have a pelvic examination and men may have a digital rectal examination.
There is no cure specifically for painful bladder syndrome, so treatment involves addressing the symptoms and making lifestyle changes.
Rarity: Rare
Top Symptoms: fatigue, abdominal cramps (stomach cramps), depressed mood, pelvis pain, arthralgias or myalgias
Urgency: Primary care doctor
Orchitis
Orchitis occurs when one or both testicles are inflamed. This is often caused by sexually transmitted infections like gonorrhea or chlamydia. More rarely, orchitis is caused by a virus.
Antibiotics are needed to treat bacterial orchitis. If the cause is viral, ibuprofen, acetaminophen, and ice packs may be used to treat symptoms.
Rarity: Rare
Top Symptoms: spontaneous testicle pain, fever, tender testicular swelling, muscle aches, new headache
Urgency: Primary care doctor
Non-serious testicle injury
Being struck in the testicles is very common, and despite the intense pain that follows, rarely requires professional medical care.
You can treat your painful scrotal injury with rest and optional application of ice. Be careful not to ice your scrotum for more than a couple minutes at a time.
Rarity: Rare
Top Symptoms: testicle pain from an injury, testicle injury
Symptoms that always occur with non-serious testicle injury: testicle injury
Urgency: Self-treatment
Groin nerve irritation
There are several nerves supplying the groin, inner thigh and genital region. Entrapment or irritation of one of these nerves can result in pain or numbness in this area. This is often caused by surgery in this area but can happen without a specific cause as well.
You should discuss your symptoms with your primary care physician. Sometimes a referral to a specialist is needed. Treatment often includes an injection with a local anesthetic.
Rarity: Rare
Top Symptoms: thigh numbness, groin numbness, testicle numbness, sharp testicle or scrotum pain, sharp groin pain
Urgency: Primary care doctor
Groin hernia
A groin hernia, also called an inguinal hernia, means that a structure in the lower abdomen – a loop of intestine or a section of fat – has pushed through the muscles of the abdominal wall. This creates a bulge, or hernia, that can be seen and felt in the groin.
A hernia is caused by a weak spot in the abdominal wall muscles, which can separate under heavy lifting or repeated straining. The weakness may be inherited or may be from previous surgery, injury, or pregnancy.
Symptoms include a bulge low down in the abdomen, most visible when the person stands; and pain in the bulge with any strain on the abdominal muscles, such as lifting a heavy object or bending over.
A hernia will not heal on its own. There is the risk of serious complications if the blood supply to the herniated organ becomes reduced or cut off.
Diagnosis is made through physical examination and x-ray or CT scan.
A small hernia may need no treatment. A larger one can be repaired with surgery.
Rarity: Uncommon
Top Symptoms: pain in the lower right abdomen, pain in the lower left abdomen, groin pain, testicle pain, groin lump
Urgency: Primary care doctor
Epididymitis
The epididymis is a coiled tube which stores sperm inside each testicle. Epididymitis is an inflammation of one or both of these tubes.
It is caused by a bacterial infection, most often from sexually transmitted diseases (STDs) such as chlamydia and gonorrhea. Epididymitis can also be caused by a urinary tract or prostate infection, or by trauma due to injury or heavy lifting.
Males of any age can be affected, though men engaging in unprotected sex are most susceptible.
Symptoms include redness, swelling, and pain in the testicle; pain on urination or ejaculation; discharge from the penis; and blood in the semen.
Any of these symptoms should be treated by a medical provider as soon as possible in order to prevent abscess or permanent damage.
Diagnosis is made through physical examination; penile swab for STD tests; urine and blood tests; and sometimes ultrasound of the testicles.
Treatment involves antibiotics as well as rest, cold packs to the testicles, wearing an athletic supporter, and refraining from lifting and sexual intercourse until the infection is gone.
Chronic prostatitis
Chronic prostatitis is an ongoing inflammation or infection of the prostate gland, the small, walnut-shaped organ just below the bladder in men.
Prostatitis is most often due to common bacteria in the urine causing infection. It may also be caused by surgery or other trauma setting up an inflammation. In some cases, the cause remains unknown.
Men of all ages are susceptible. Risk factors include a past urinary tract infection; using a catheter for urination; or pelvic trauma from bike riding or horseback riding.
Symptoms include pain in the abdomen, low back, groin, and genitals; frequent need to urinate; pain, burning, and difficulty when urinating; urine that is cloudy or bloody; and painful ejaculation.
A medical provider should be seen for these symptoms, since a bacterial infection can spread and lead to scarring, pain, and infertility.
Diagnosis is made through urine tests, blood tests, and ultrasound or CT scan.
Treatment involves antibiotics for bacterial prostatitis, though if all the bacteria are not destroyed the disease can become chronic. Nonsteroidal anti-inflammatory drugs are also helpful.
Possible treatments for your scrotum pain
When it is an emergency
Seek immediate treatment in the emergency room or call 911 if you have sudden, severe pain and obvious swelling in one testicle, especially with no apparent cause. This set of symptoms is usually due to torsion. Treatment must begin within two to four hours at most, or there can be a loss of blood supply. Surgery is usually necessary to save the testicle or to remove it to prevent gangrene.
When to see a doctor
See a doctor promptly if you experience any of the following.
- Dull pain in the testicle that comes on gradually: It may radiate down from, or up into, the lower abdomen.
- You have a fever, chills, and burning with urination
At-home treatments
To address mild or temporary pain in one testicle, try the following.
- Rest
- Ice packs: For short periods, such as 15–20 minutes a few times per day.
- Pain medication: Try over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) to soothe the pain.
Questions your doctor may ask about pain in one testicle
- Do you feel pain when you urinate?
- Are you sexually active?
- Do you notice anything going on with your testicles or scrotum?
- Have you experienced any nausea?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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