Pain in one testicle can be in either the right or left testicle. Sharp pain in the testicle can be caused by testicular torsion, an injury to the groin, a bacterial infection, or prostatitis. Sudden, severe pain in a testicle is very serious and must be treated immediately.
8 most common causes
What can cause testicle pain?
There are many reasons that a testicle may start to hurt, including from a torsion or inflammation. You may feel pain on just the right or left side, or both testicles can be affected. You may also have testicular swelling, lower abdomen pain, and burning when urinating.
A testicular torsion is when the spermatic cord (the testicular blood supply) is twisted. A torsion occurs most often on the left side and rarely affects both sides at once. A trauma or injury from an accident, sports injury, riding a horse or bicycle, hematoma, contusion, or rupture of the testicle can lead to a torsion.
Inflammation from prostatitis or a sexually transmitted disease can damage the epididymis, the long, coiled tube that carries semen, and cause scarring and pain. Inflammation is likely to be from prostatitis or a sexually transmitted disease.
Common causes
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1. Epididymitis
Epididymitis is an inflammation of the epididymis. The epididymis is a coiled tube inside each of the two testicles that stores sperm.
Epididymitis is a bacterial infection, most often from sexually transmitted diseases (STDs) like chlamydia and gonorrhea. It can also be from a urinary tract, prostate infection, or even an injury.
It affects men of any age, but men who have unprotected sex are at higher risk of getting it.
Other symptoms you may have
- Redness, swelling, and pain in the testicle
- Pain when urinating or ejaculating
- Discharge from the penis
- Blood in the semen
Treatment and urgency: See a medical provider as soon as possible to avoid permanent damage. Treatment involves antibiotics along with rest, cold packs to the testicles, wearing an athletic supporter, and not lifting or having sexual intercourse until you no longer have an infection.
2. Inguinal hernia
An inguinal hernia, also called a groin hernia, is when a part of the lower abdomen—like a loop of intestine or a section of fat—pushes through a weak spot in the abdominal wall muscles. You may be born with the weakness or it can be from a previous surgery, an injury, or pregnancy.
Other symptoms you may have
- A bulge and pain low down in the abdomen—you may see the bulge when standing up.
- The bulge starts to hurt when there is pressure on the abdominal muscles, like from lifting a heavy object or when bending over.
Treatment and urgency: A hernia doesn’t heal on its own, and it can get bigger over time. There is also a risk of serious complications. Depending on the size of the hernia, your provider may want to wait to repair it or decide to do surgery right away.
3. Orchitis
Orchitis is when one or both testicles are inflamed. It is often caused by sexually transmitted infections like gonorrhea or chlamydia. More rarely, orchitis is caused by a virus.
Other symptoms
- Sudden testicle pain and swelling
- Fever
- Muscle aches
- Headache
Treatment and urgency: See your provider right away. If the orchitis is from a bacteria, you will be prescribed antibiotics. If it’s viral, ibuprofen, acetaminophen, and ice packs may help symptoms.
4. Prostatitis
Prostatitis is most often from bacteria in the urine that causes an infection in the prostate gland. It can also be from inflammation after surgery or other trauma. In some cases, the cause is unknown. Chronic prostatitis is an ongoing inflammation or infection of the prostate gland.
Men of any age can get it. Risk factors include urinary tract infections; using a catheter to urinate; or pelvic trauma from activities like bike riding and horseback riding.
Other symptoms
- Pain in the abdomen, low back, groin, and genitals
- Frequent need to urinate
- Pain, burning, and difficulty when urinating
- Cloudy or bloody urine
- Painful ejaculation
Treatment and urgency: See a provider. An untreated bacterial infection can spread and cause scarring, pain, and infertility. If it is bacterial, you will be prescribed antibiotics. Nonsteroidal anti-inflammatory drugs can also help.
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5. Testicular torsion
Testicular torsion is a twisting of the spermatic cord. Each testicle has a spermatic cord that goes up into the abdomen and carries blood vessels, nerves, and sperm-transporting ducts. The twisting of the cords cuts off the blood supply to the testicles. It is a medical emergency.
The cause of a testicular torsion is believed to be a congenital abnormality (something you were born with) that allows the testicles to move around in the scrotum. It is most likely to happen to infant boys and boys just reaching puberty. But older boys can get testicular torsion after an injury or an athletic workout.
Other symptoms
- Sudden, severe, testicular pain and swelling—usually on just one side
- Nausea and vomiting
Treatment and urgency: Acute testicular torsion needs to be treated right away. It can lead to infertility and permanent damage to the testicle. You need to go to the ER or call 911.
Typically, surgery is needed to untwist the testicle. In rare cases, the testicle may have to be removed. Sometimes the provider may first try to manually rotate the testicle back into place
What is most likely to cause testicle pain?
Pain is more likely just before and during sexual activity, after ejaculation, and during or after exercising. You may have pain when you are awake, asleep, standing, sitting, or moving.
It is possible for any man to have testicular pain, but men who have unprotected anal or vaginal sex or are very sexually active are at higher risk. Teenage boys, young men, and baby boys are more likely to have testicular pain from a torsion of the testicle.
Common symptoms of pain in one testicle
These are some of the symptoms you are likely to have.
- 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
- The testicle may seem to be hanging or lying in an unusual position or placed higher than normal within your scrotum.
At-home treatments
For mild testicle pain, you can try the following.
- Resting
- Applying ice packs for short periods, like 15–20 minutes, a few times per day.
- Taking pain medication. Try over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) to relieve the pain.
When to get medical help
You should see a doctor right away if you have dull pain in the testicle that starts slowly. It may feel like it’s coming from or going into the lower abdomen. Also see a doctor if you have fever, chills, and burning when urinating.
Go to the ER or call 911 if you have sudden, severe pain and swelling in one testicle, especially when you do not know what is causing it. It may be from a torsion, which needs to be treated as soon as possible.
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Questions your doctor may ask about testicle pain
- Do you feel pain when you urinate?
- Are you sexually active?
- Do you notice any changes in your testicles or scrotum?
- Are you feeling nauseous?
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