Testicular Pain: Causes, Symptoms, and Treatment Options

Scrotal pain

Doctor, I have been experiencing a pressure sensation in my left testicle whenever I sit down.
I visited a urologist who examined me, conducted a urinalysis, and performed an X-ray.
The doctor said there were no significant issues and suggested that I might be experiencing nerve pain due to prolonged sitting.
I was prescribed pain relievers, gastric medication, and muscle relaxants, with the expectation that I would feel better in about three to four days.
However, I only took the medication for one day and then stopped.
Now, instead of just feeling pressure when sitting, I occasionally experience a cramping pain, even when standing.
The discomfort lasts for about one to two minutes, but it’s not very painful—just noticeable.
Is this nerve pain, or could there be another underlying condition that hasn't been diagnosed? Or is it because I didn't consistently take the medication? My mother keeps saying that taking painkillers is not good for me, so I don't want to take them.

ABC, 10~19 year old female. Ask Date: 2005/03/05

Dr. Lin Wenxu reply Urology

Hello, based on your description, your condition seems to be what is referred to as "chronic testicular pain." There can be many potential causes (e.g., hernia, varicocele, hydrocele, testicular tumor, chronic prostatitis, and epididymitis, among others).
Most patients may experience spontaneous resolution of their pain, but it can be recurrent.
In fact, many patients are unable to identify a specific cause.
Additionally, I recommend wearing looser-fitting pants, as prolonged use of tight clothing, such as jeans, can contribute to chronic testicular pain.
Regardless, if your symptoms persist, please remember to visit a urology clinic for a thorough examination.
Lin Wen-Hsu

Reply Date: 2005/03/05

More Info

Testicular pain can be a complex issue, and understanding its causes, symptoms, and treatment options is crucial for effective management. Based on your description, it seems you are experiencing discomfort in your left testicle, particularly when sitting, and you have also noted intermittent sharp pain that occurs even when standing.

Causes of Testicular Pain
1. Nerve Compression or Irritation: Given that you mentioned prolonged sitting, it's possible that you are experiencing nerve compression, which can lead to referred pain in the testicular area. This is often due to pressure on the nerves that innervate the groin and testicular region.

2. Musculoskeletal Issues: Sometimes, pain can arise from musculoskeletal problems, such as tightness in the pelvic floor muscles or issues with the lower back that can refer pain to the testicles.

3. Inguinal Hernia: An inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. This can cause discomfort in the testicular area, especially when sitting or standing for long periods.

4. Epididymitis or Orchitis: These are conditions characterized by inflammation of the epididymis or testicle, respectively. They can cause pain and discomfort, but typically would present with additional symptoms such as swelling, redness, or fever.

5. Referred Pain: Sometimes, pain in the testicles can be referred from other areas, such as the lower back or abdomen, due to nerve pathways.

Symptoms to Monitor
- Duration and Intensity: You mentioned that the pain lasts for a minute or two and is not severe. However, keep track of any changes in duration, intensity, or frequency.

- Associated Symptoms: Look for any additional symptoms such as swelling, redness, fever, or changes in urination. These could indicate a more serious condition that requires immediate medical attention.

- Response to Medication: You noted that you stopped taking the prescribed medications after one day. While it's understandable to be cautious about medication, especially painkillers, they can sometimes help alleviate symptoms and allow you to engage in physical therapy or other treatments more effectively.

Treatment Options
1. Medications: While you have concerns about taking pain medications, they can be beneficial in managing acute pain. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce inflammation and pain. If your doctor prescribed muscle relaxants, they may help if muscle tension is contributing to your discomfort.

2. Physical Therapy: Engaging in physical therapy can be beneficial, especially if the pain is related to musculoskeletal issues. A physical therapist can provide exercises to strengthen the pelvic floor and lower back, which may alleviate pressure on the nerves.

3. Lifestyle Modifications: Consider adjusting your sitting habits. Using ergonomic chairs or taking regular breaks to stand and stretch can help reduce pressure on the nerves and improve circulation.

4. Follow-Up Care: If your symptoms persist or worsen, it’s important to follow up with your healthcare provider. They may recommend further imaging studies or referrals to specialists, such as a urologist or neurologist, to rule out any underlying conditions.

5. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture or chiropractic care, which may help with nerve pain and musculoskeletal issues.

Conclusion
While your initial evaluation did not reveal any significant issues, the persistence of your symptoms warrants further attention. It’s essential to communicate openly with your healthcare provider about your concerns and the effectiveness of any treatments you try. If you are hesitant about medications, discuss alternative pain management strategies with your doctor. Remember, managing pain effectively often requires a multifaceted approach, including lifestyle changes, physical therapy, and, when appropriate, medication.

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