Can Herniated Discs Cause Testicular Pain? the Connection

Could it possibly be a herniated lumbar disc?

Hello, Dr.
Hsu! I recently came across a clinical report online (content as follows): Mr.
Jiao, a 35-year-old man, has been experiencing frequent pulling pain in his testicles, accompanied by discomfort in the groin area.
He was diagnosed with varicocele at a community hospital, and the attending physician recommended a minor surgery.
Upon hearing about the surgery, Mr.
Jiao felt uneasy and sought a second opinion from a specialist at a city hospital.
After examination, the specialist concluded that Mr.
Jiao's varicocele was mild and should not cause such frequent pain.
Upon further inquiry into his medical history, it was noted that Mr.
Jiao also experienced inner thigh pain, particularly worsening with prolonged sitting or walking.
An MRI was performed, revealing a herniated disc at the lumbar levels 1-2, leading to the conclusion that the testicular pain was likely caused by this condition.
Dr.
Hsu mentioned that there is a discrepancy between sciatica and varicocele symptoms! However, the report suggested that the testicular pain caused by the herniated disc might be sharp, similar to the sensation of being hit by a ball.
Is the pain in the testicles and perineum caused by the lumbar disc herniation something that is present daily, unlike the intermittent pain associated with varicocele? I wonder if Dr.
Hsu has encountered similar clinical cases that he could share? This would provide me with a reference for my medical treatment or surgery.
Thank you for your explanation.

A-Jia, 30~39 year old female. Ask Date: 2012/11/10

Dr. Xu Weikai reply Urology

The symptoms caused by a herniated disc depend on which segment of the spine is affected, as the clinical manifestations vary by segment.
For detailed distinctions in symptoms, it is advisable to consult specialists in neurology, rehabilitation medicine, or orthopedics.
Sciatica occurs when the sciatic nerve is compressed, and the symptoms will follow the path of the sciatic nerve: from the buttock, down the back of the thigh, to the popliteal fossa, along the back of the calf, and into the heel.
Only then can it be classified as sciatica.
Compression of other nerves will present different symptoms and should not be referred to as sciatica; nerve pain due to spinal compression is often related to posture.
Specific positions, such as bending forward, leaning back, or lateral bending, can influence the intensity of the pain.
Generally, nerve pain starts as severe and sudden sharp pain; if it becomes chronic, it may transition to a dull ache.

Testicular pain can have many causes, including orchitis, varicocele, kidney stones, herniated discs, spinal inflammation, and bone spurs.
Varicocele pain often occurs after prolonged standing, heavy lifting, or in the evening, and the intensity can vary from person to person.
Typically, lying down alleviates the discomfort.
Therefore, patients often report feeling fine in the morning but experiencing increasing pain by the time they return home from work.

Note: For spinal issues, it is recommended to consult the aforementioned specialists for professional advice.
If you insist on getting an MRI, discuss its necessity with your physician.

Reply Date: 2012/11/10

More Info

Herniated discs can indeed cause testicular pain, although this is not a common presentation. The connection between a herniated disc and testicular pain primarily involves the complex anatomy of the lumbar spine and the nerves that originate from it.
When a disc herniates, it can protrude into the spinal canal and compress nearby nerves, particularly the nerve roots that exit the spine. In the lumbar region, these nerve roots can affect not only the lower back and legs but also the pelvic region, including the testicles. The nerves that innervate the testicles originate from the lumbar and sacral plexus, specifically from the T10 to L1 spinal segments. Therefore, if a herniated disc at the lumbar level compresses these nerves, it can lead to referred pain in the testicular area.

The pain associated with a herniated disc is typically described as a deep, aching pain that may radiate down the leg (sciatica) or into the groin and testicular area. Patients may experience a variety of sensations, including sharp, stabbing pain, a dull ache, or a feeling of heaviness. The pain may be exacerbated by certain movements, such as bending, lifting, or prolonged sitting, and it may not be constant. This is different from pain caused by conditions like varicocele (enlarged veins in the scrotum), which can cause a more localized, intermittent aching sensation that may worsen throughout the day or with prolonged standing.

In the case of Mr. Jiao, as described in the clinical report, his testicular pain was associated with other symptoms such as discomfort in the groin and inner thigh pain, particularly after prolonged sitting or walking. This pattern suggests that the pain may indeed be related to nerve compression from the herniated disc rather than solely due to the varicocele.
If a herniated disc is the underlying cause of testicular pain, the pain may not be constant and could vary in intensity, similar to how sciatica presents. Patients may experience episodes of pain that correlate with their activity levels or positions. In contrast, varicocele-related pain is often more consistent and may be influenced by factors such as temperature or physical activity.

In terms of management, if a herniated disc is suspected to be the cause of testicular pain, it is essential to address the underlying spinal issue. This may involve conservative treatments such as physical therapy, pain management with anti-inflammatory medications, or epidural steroid injections. In cases where conservative management fails, surgical intervention may be considered to relieve nerve compression.

It is also crucial to differentiate between the potential causes of testicular pain, as other conditions such as infections, trauma, or tumors may present similarly. Therefore, a thorough evaluation by a healthcare professional, including imaging studies like MRI, is necessary to confirm the diagnosis and guide appropriate treatment.

In summary, while herniated discs can cause testicular pain through nerve compression, the presentation can vary. It is essential to consider all potential causes of the pain and to work closely with a healthcare provider to determine the best course of action. If you are experiencing persistent or severe pain, it is advisable to seek medical attention for a comprehensive evaluation and tailored treatment plan.

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