Pain in the Testicle or Scrotum (No Swelling)

Often, the scrotum or testicle is not swollen, but there is a dull, throbbing pain or discomfort on one side that may become worse during the day. In severe cases, even the touch of clothing or bedclothes makes it worse.

This is a common problem, and there are many possible causes, including an infection. Pain in the scrotum can occur after a vasectomy; no-one understands why this happens, but it seems to affect up to 6% of men who have had a vasectomy.

What your doctor can do. If you have pain in the scrotum or testicle you need to see your doctor, or go to a genitourinary medicine clinic. Your doctor will test you for infection, and will try to work out the cause of the pain. Even if no infection is evident, your doctor may prescribe an antibiotic. Your doctor may prescribe a low dose of amitriptyline; this is a drug that helps to block pain. (In higher doses it is also used as an antidepressant, but not in this case.) Pelvic floor physiotherapy can help, but it is available only in specialized hospitals.

Often, however, no particular cause can be found, in which case you have ‘testicular pain syndrome’.

What you can do. If you have testicular pain syndrome, it makes sense to avoid anything that makes it worse, such as riding a bike or horse-riding. Painkillers such as paracetamol (acetaminophen) or a non-steroidal anti-inflammatory medication can help a lot. The good news is that although testicular pain syndrome can continue for weeks, months or even years it usually improves. However, it may then return from time to time so do not be too discouraged if this happens.

Swollen, Painful Testicle(s)

Cancer of the testicle is usually painless, but in a few cases it is painful, so it is important that you get any swelling examined by a doctor. For more information see our sections on Swellings, lumps and enlarged testicle(s) and Lumps on genitals in men.

Gradual swelling and pain. A swollen, painful testicle that has come on gradually (perhaps over a few hours or days) is likely to be caused by an infection. This is called ‘epididymo-orchitis’. It usually occurs on one side only, but sometimes both sides are affected together. The skin over the testicle may be red and shiny. There may be a discharge from the penis.

The cause may be a virus (such as mumps) or various bacteria. It can follow a urine infection (see Cystitis in men), especially in older men. It can also be caused by sexually transmitted bacteria such as chlamydia or gonorrhoea. If you live in a tropical country, or have recently visited one, a worm called ‘filaria’ can get into the scrotum and make it swell up. This may or may not be painful.

You need to see your doctor as soon as possible for some simple tests and antibiotic treatment, and you will need to use a scrotal support (‘jock strap’).

Severe, sudden swelling and pain. If the pain is very severe and has come on suddenly, it is possible that the testicle and its tubing have become twisted within the scrotum (known as ‘testicular torsion’). This is most common in adolescents, but can occur at any age. You must contact your doctor straight away, or go to the nearest hospital emergency department.


First published on:
Reviewed and edited by: Matt Brewer
Last updated: May 2021

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