Possible Causes of Pain in the Testicles

Experiencing testicular pain can be uncomfortable both physically and psychologically. If your balls hurt, you may be embarrassed to seek medical care and have to discuss your symptoms with a scheduler, nurse, doctor, and other healthcare providers.

The problem is that there are some serious conditions that can cause testicle pain. This symptom is worth a trip to the doctor to get a solution and prevent complications.

Doctor talking to patient in medical practice
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Epididymitis

Epididymitis is an infection in the epididymis (the tube that runs from the testicle to the vas deferens). It is usually caused by an infection, which means only a prescription will help, and you will have to see a healthcare provider. There's no first aid help for epididymitis.

The most common infections that cause epididymitis are sexually transmitted diseases.

Orchitis

Orchitis is inflammation of the testicles. The suffix "-itis" simply means inflammation, while orches means testicle

Orchitis is usually caused by an infection that has settled in the testicle itself. Most cases of viral orchitis come from the mumps virus. Orchitis can also come from epididymitis that's left untreated.

Orchitis needs to be treated because it can lead to plenty of complications if it's not, including sterility.

Testicular Torsion

Testicular torsion is a true medical emergency that requires surgery and it has a very short deadline. If it's not treated, the testicle may be lost.

Besides pain, look for the affected testicle to be hanging higher than it usually does. It might not, but that's a bad sign if it is. Testicular torsion is usually a young person's condition (ages 10 to 20 years old). Older people can get it, but that's rare.

Epididymal Hypertension (Blue Balls)

After a long period of arousal without ejaculation, there is significant pressure and pain in the testicles. The pain at times might even be described as debilitating.

Most people aren't willing to talk about it, so explanations of this phenomenon most often come from the informal places where many young people learn the answers to their questions on sexual issues, such as stand up comedy or online searches.

The good news is that you are not going to die or lose a testicle. This will resolve on its own within a short period of time.

This is the only condition on this list that doesn't require a visit to your doctor. If you are a parent, you may want to include a discussion of blue balls with your talks on sexuality with your child.

Inguinal Hernia

A hernia occurs when a weak spot in muscle ruptures and allows internal tissues or organs (viscera) to protrude from the defect. The most common spot for this to happen is in the groin area. It's called an inguinal hernia.

You may have seen old basketballs or bike tires that split and the rubber inner part that held the air has started poking out through the hole. Those are examples of what happens in a hernia.

This type of hernia can happen in people of any sex or gender. It will not go away on its own and will require surgical repair. It becomes a medical emergency if it becomes stuck in the "out" position and is starved of blood supply.

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  1. Cleveland Clinic. Epididymitis. Updated February 7, 2018.

  2. Trojian TH, Lishnak TS, Heiman D. Epididymitis and Orchitis: An OverviewAmerican Family Physician. 2009;79(7):583-587.

  3. The Official Foundation of the American Urological Association. Testicular torsion.

  4. Cleveland Clinic. Hernia. September 27, 2018.