5 Common Causes of Testicular Pain and How to Diagnose Them

Written by: Tommy Buckley

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Time to read 7 min

Have your balls been aching, and you’re wondering what’s causing the problem? Or, are you experiencing sharp, intense testicular pain and wondering whether to rush to the hospital? 


Testicular pain is a common symptom that men go through and secretly suffer in silence. Or they quietly go to their doctor to get testicular pain diagnosed and rarely mention it to anyone.  


It's hard to bring up a discussion about your balls aching with your mates or significant other without raising eyebrows. 


It’s time to combat the problem once and for all. We delve into what could be causing the dull ache or intense pain you feel in your gonads and give you pointers on when you need to worry.


The common causes of testicular pain are: 


  • Testicular torsion
  • Inguinal hernia
  • Testicular trauma
  • Testicular tumor
  • Kidney stones
Common Causes of Testicular Pain

Cause #1: Sudden Testicular Torsion

Testicular torsion occurs when the ball twists and the spermatic cord spins.  This causes complete or partial blockage of blood flow to the nuts and scrotum.


The lack of blood flow to the gonads leads to severe ball pain and scrotal swelling. Ballbag swelling makes your boys appear larger than normal and become extra sensitive. Testicular torsion can occur at any age with no particular cause, but it's more common between 12–25 years.


Suspect testicular torsion if you have:

  • Larger than normal ball size: Average size is 3cm to 5cm long and 2cm to 3cm wide.
  • Bell-clapper deformity: Your balls hang extra loosely.
  • Underlying testicular injury through trauma. 

Other symptoms of testicular torsion apart from testicle pain are:

  • Swollen ball bag
  • Low abdominal pain 
  • Frequent urination
  • An abnormally high-placed ball
  • Nausea and vomiting

If you have any of these symptoms or if you experience testicular pain, we recommend doing a self-examination at home. You might want to trim and groom any pubic hair before the self-examination to make sure you have a clear view of your testicles and the surrounding area.

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When to Worry

Testicular torsion is an emergency that needs immediate medical attention to restore blood flow to the affected ball. You need to worry and seek treatment as soon as you feel sudden unbearable sharp pain, to which medication offers no relief.


If you wait for more than 6 hours for surgery, you could end up losing your ball. You risk total blood supply disruption at the spermatic cord, leading to testicular cell death.

Cause #2: Inguinal Hernia That Causes Testicle Pain

Inguinal hernias occur when the contents of the abdomen bulge through a weak point in the abdominal muscles. The small intestine and fatty tissue enter the groin and scrotal sac, causing testicular and scrotal pain. 


You’ll feel a dull ache while walking, exercising or changing from standing to sitting position and vice versa. When landscaping your nuts, this is the perfect time to check for abnormalities. Due to the extra load in your sack, you’ll notice your balls are extra big or look swollen.


The symptom onset and testicular pain intensity vary depending on the size of the hernia. The more abdominal content fills the ball bag, the more severe the testicular pain


Medical care for small hernias involves gently returning the abdominal content back to the abdomen. This is done by manipulating the scrotal sac organs. In situations where the content protrudes back, further surgical or medical treatment is required.

When to Worry 

You need to worry and seek emergency medical attention when the pain in the affected ball becomes unbearable. 


Severe testicular pain in this situation could mean the abdominal content is being strangled. This causes an interrupted blood supply to the scrotum and balls. Immediate surgical intervention is needed to relieve pain and save your nuts.

Cause #3: Testicular Trauma Leading to Severe Pain

All men have experienced testicular pain at some point when their balls were kicked, struck, hit or crushed. The pain comes flooding back as you recall that dreadful incident. Testicular trauma is the third leading cause of acute scrotum, which means sudden agonising testicular pain. 


Mild or severe testicular trauma depends on the impact of the injury and the organs in the scrotal sac affected. Other organs that surround your balls and directly affect them in case of trauma include:


  • Vas deferens
  • Spermatic cord
  • Testicular appendage
  • Lymphatic vessels 

The severity of injury to your balls increases If any of these minor organs are involved.

The four most common testicular traumatic injuries present themselves in different ways. 


Injury

Presentation

Testicular rupture

Gonads protective layer tears injuring one or both testicles

Testicular contusion

A blunt injury that causes bruising and bleeding 

Testicular torsion

Twisted testicle after injury

Testicular dislocation

When the balls are kicked out of the ball bag


If a recent testicular injury due to trauma occurred and pain medication hasn’t helped, a visit to a healthcare professional is a must. They’ll treat testicular pain efficiently after conducting a detailed physical exam and imaging.

When to Worry

All balls deserve the right to be checked after trauma. You should feel concerned after a testicular injury when: 


  • Your balls continue to hurt hours after the traumatic injury.
  • There’s swelling, which is increasing in size.
  • Excruciating pain when you perform simple tasks. 

Book an appointment with a healthcare professional who’ll provide medical advice on the diagnosis and the best course of action.

If you prefer or feel more comfortable, you can shave your balls before your appointment. Your doctor will examine your gonads to make an accurate diagnosis, so do what makes you feel most at ease.

Cause # 4: Testicular Cancer

According to The American Cancer Society, about one in every 250 men will develop testicular cancer in their lifetime. The survival rate is 96–99% when detected early. Why not donate now and help find a cure for cancer.


Testicular cancer commonly affects males between the ages of 15–35 years, with 6% of the cases occurring in children and 8% in men over 55. 


Testicular pain due to testicular tumors is considered a late early warning sign. Try and remember if you’ve had and still have the following early symptoms, long before the onset of testicular pain:

 

  • A slow progressive change in the size and shape of your balls.
  • Your nuts feel heavy. 
  • Your gonads are swollen or extra thick.
  • Testicular mass that’s firm, slow-growing, and painless.

Looking out for these four pointers may seem challenging. But when you perform checks frequently, you can easily observe and feel these changes in your boys.

 

Here's a tutorial on how to inspect your balls:

When to Worry

Seek urgent medical attention as soon as you feel a firm or hard mass in your balls. You may notice your testicle lies next to the mass or find it hard to differentiate between your ball and the mass. 


You need to worry about such a lump even when it's painless and seek medical advice. Let your doctor exclude testicular cancer with imaging and blood tests.

Cause #5: Acute or Chronic Kidney Stones

Kidney stones are deposits of minerals and salts in your kidney. They clump together and form small crystals the size of grain up to the size of a golf ball.

 

Small kidney stones pass in urine unnoticed. Others grow until they cause testicular pain due to continued exposure to influencing factors.

 

Below are some risk factors you need to consider. They’ll help you to discover whether an uncomplicated kidney stone is causing your testicular pain.

 


Risk Factor

How it Causes Tumors

Diet

Foods high in sodium, protein, and sugar.

Obesity

Metabolic imbalances lead to more minerals in the body.

Insufficient water intake

Prevents the dilution of minerals and salts.

Frequent urinary tract bacterial infection

Bacteria produce enzymes that reduce the acidity of urine, making it favorable for crystal formation.


 

When these stones move and touch the walls of the kidney or ureter, they cause excruciating pain. You also experience testicular pain


The ball pain you feel is called referred pain. It isn't coming directly from your balls but from other sections of your male urinary system—due to shared spinal nerves.


If a kidney stone is causing testicular pain, you’ll have additional symptoms such as:


  • Some blood in the urine
  • Burning sensation while urinating
  • Frequent visits to the men's room
  • Pain at the edge of your penis
  • Cramping groin pain that radiates to the back

When to Worry

Become concerned when you experience any of the symptoms mentioned here. Or if you have unbearable testicular pain when passing urine.


Kidney stones have several medical treatment options depending on the size of the crystals. The non-invasive method is applied for tiny crystals and surgical intervention for big stones.

Check Your Balls Regularly for Abnormalities

When your balls hurt, everywhere hurts. Testicular pain causes significant worry for men. Any sign of discomfort immediately changes how they function. That's why testicular pain needs intervention sooner than later. 


Frequent inspection of the balls helps you detect and manage any abnormalities before they become more serious or cause pain. 


Trim and check your boys regularly for the sake of their health and well-being.