Written and clinically reviewed by Mr Daniel Swallow, Consultant Urologist (GMC 6128674). Last reviewed: .
Sudden, severe pain in one testicle, especially with swelling, nausea or vomiting, may be testicular torsion (twisting of the cord). It can happen at any age, is most common in teenagers and young men, and the testicle may be lost if it is not treated within hours. Do not wait to see if it settles, and do not wait for an appointment. Go to A&E straight away, or call 999 if you cannot get there quickly.
Is testicular pain normal?
Mild, short-lived aching can follow a knock, heavy lifting or a long time without release, and often settles on its own. Pain that is persistent, worsening, or comes with a lump, swelling, redness or a fever should be checked.
Common causes
- Epididymitis or epididymo-orchitis: infection or inflammation, causing swelling, tenderness and sometimes a fever.
- Torsion: see above. A medical emergency.
- Hernia or varicocele, causing a dragging ache that is worse on standing.
- Referred pain from a kidney or ureteric stone, or from a nerve in the back or groin, even when the testicle itself looks normal.
- Chronic scrotal pain, where pain is constant or intermittent, lasts at least three months and affects daily life. It can follow infection, a hydrocele or varicocele, or a vasectomy, and can be referred from elsewhere. It is real, often manageable, and worth specialist assessment.
- Cancer is a less common cause and usually presents as a painless lump, but any lump should be checked (see scrotal lumps).
See a doctor promptly if you find a lump or swelling, if pain lasts more than a few days, if there is redness or a fever, or if the pain keeps coming back.
What an assessment involves
A history and careful examination, a urine test, and often a scrotal ultrasound. Many causes are straightforward to treat, for example with antibiotics for infection or a simple operation for a hernia or varicocele. For chronic pain, treatment is aimed at relieving the symptoms and looking for any contributing cause.
Common questions
How can I tell whether it is torsion?
Torsion usually comes on suddenly and severely, often with nausea or vomiting, and the testicle may sit higher or look different. If in any doubt, go to A&E. Doctors would always rather see you than miss it.
Can a kidney stone cause testicular pain?
Yes. A stone moving down the ureter can refer pain to the groin and testicle on the same side. If you also have loin pain, blood in the urine or sickness, a stone is a possible explanation.
Can testicular pain be treated?
In most cases yes. The treatment depends on the cause, from antibiotics and pain relief to minor surgery. Long-standing pain with no clear cause can often be eased with a structured approach.
Discuss this with Mr Swallow in London or Chelmsford
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Further reading from trusted sources
Information on this page follows patient guidance published by the British Association of Urological Surgeons (BAUS). External links open on the NHS and NICE websites, which are not run by Mr Swallow.