1. Spinal nerve compression
Spinal problems are commonly overlooked causes of testicular pain in men. Some examples include:
- Facet joint osteoarthritis. Degeneration of a facet joint can lead to bone spurs (osteophytes) and narrowing of the intervertebral foramen, which can impinge a spinal nerve. If the L1 spinal nerve is compressed, it could radiate pain and/or tingling into a testicle on the same side. Similar symptoms could occur with spinal nerve compression anywhere from the bottom of the thoracic spine to the top of the lumbar spine (T10 down to L2). 1 Patel AP. Anatomy and physiology of chronic scrotal pain. Tranl Androl Urol. 2017; 6(Suppl 1):S51-56. doi: 10.21037/tau.2017.05.32
See Osteoarthritis of the Spine
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- Herniated disc. If a disc herniates and inflames any of the spinal nerves from T10 to L2, it could also radiate pain and/or tingling into a testicle on the same side. 1 Patel AP. Anatomy and physiology of chronic scrotal pain. Tranl Androl Urol. 2017; 6(Suppl 1):S51-56. doi: 10.21037/tau.2017.05.32
See Lumbar Herniated Disc: What You Should Know
- Sacroiliac joint dysfunction. Any type of dysfunction or degeneration that develops in the sacroiliac (SI) joint could potentially compress sacral spinal nerves. If S2, S3, or S4 becomes compressed, it could radiate pain into the scrotum. 1 Patel AP. Anatomy and physiology of chronic scrotal pain. Tranl Androl Urol. 2017; 6(Suppl 1):S51-56. doi: 10.21037/tau.2017.05.32 , 2 Leone JE, Middleton S. Nontraumatic testicular pain due to sacroiliac-joint dysfunction: a case report. J Athl Train. 2016; 51(8):651-7.
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See Sacroiliac Joint Dysfunction (SI Joint Pain)
Other spinal levels or problems in the spine may also be capable of referring pain down to the testicle(s) and/or scrotum.
See Lumbar Spine Anatomy and Pain
2. Epididymitis
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Epididymitis involves inflammation of the epididymis, which is tubing located toward the back of the testicle. It is most commonly caused by a bacterial infection but can also result from a virus. Symptoms typically include testicular swelling and pain on one side, which may start out as dull but can become more intense or sharp. In some cases, pain may also be felt in the abdomen, pelvis, or low back.
See Lower Back Pain Symptoms
Epididymitis is the most common cause of acute testicular pain in the U.S. and occurs in more than 600,000 men each year. 3 Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician. 2009; 79(7):583-7. As such, it is common for this condition to be suspected in cases of acute testicular pain. While epididymitis can occur at any age, it is most likely in men ages 20 to 39. 3 Trojian TH, Lishnak TS, Heiman D. Epididymitis and orchitis: an overview. Am Fam Physician. 2009; 79(7):583-7.
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