TESTICULAR PAIN

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Testicular pain is discomfort in one or both testes, ranging from a sudden sharp injury to a dull ache that builds over time. Because the testicles carry many sensitive nerves, the pain can feel intense and distressing even when the underlying cause turns out to be minor. At Singapore Paincare, we focus on accurate diagnosis and minimally invasive treatment to relieve testicular pain and improve your daily quality of life.

Male Genital Pain Testicular Pain

What Is Testicular Pain?

The testes are two small organs located inside the scrotum, below the penis. Testicular pain can affect males of any age. It falls into two broad types: acute pain, which is sudden and short-lived, and chronic pain, which develops gradually and lasts longer. A sudden injury usually causes sharp pain first, followed by a dull ache that worsens with activity or over time.

What Causes Testicular Pain?

Testicular pain generally falls into three categories: ischemic (poor blood supply), inflammatory, or neuropathic (nerve-related) pain. The most common conditions behind it are epididymitis (inflammation of the testes), testicular torsion (a twisted spermatic cord that cuts off blood flow to the scrotum), and inguinal hernia. Most cases trace back to either a person’s biological build or an infection passed on through sexual contact.

Epididymitis is one of the most frequently diagnosed causes: international data puts its incidence at roughly 25 to 65 cases per 10,000 adult men each year, most often in men aged 18 to 35.1 Testicular torsion is less common but time-sensitive. Nationwide studies report an annual incidence of around 2 to 4.5 cases per 100,000 males, with about 86% of cases occurring in males older than 10 (median age 15).2 These figures are drawn from international population studies rather than Singapore-specific data, but they illustrate why persistent or sudden testicular pain shouldn’t be ignored.

What Are the Symptoms of Testicular Pain?

Pain

Testicular pain varies depending on its cause. It may be localised to the testes, or it may be referred pain from elsewhere in the body. A sudden injury typically causes a sharp, immediate pain followed by a dull ache. Kidney stones, for example, can cause a sharp back pain that radiates down to the testicles and penis.

Bruising and swelling

A bruise or lump may appear on the scrotum. Redness or shininess of the scrotal skin can point to an injury, orchitis, epididymitis, or a testicular tumour.

Other symptoms

Fever, nausea, vomiting, or urination problems (frequent urination, a burning sensation when urinating, or blood in the urine) can also accompany testicular pain.

How Is Testicular Pain Diagnosed?

At Singapore Paincare, our pain specialists work alongside urologists to reach a thorough diagnosis. This starts with a physical examination, a review of your symptoms, and your medical history. Blood or urine tests may be used to check for infection. If a lump is found on the testicle, an ultrasound will be ordered to check for testicular cancer.

What Treatments Are Available for Testicular Pain?

In many cases, non-surgical treatment can provide good outcomes. At Singapore Paincare, we aim to treat pain using the least invasive option appropriate, once the cause has been accurately identified. Our approach focuses on addressing the source of pain through specialised injections and minimally invasive procedures, combined where needed with medication and rehabilitative therapy, to help patients recover function and reduce the chance of pain returning.

Non-surgical Treatment Options

Anti-inflammatory drugs

NSAIDs are commonly prescribed for injuries, trauma, and orchitis. They target inflammation, reduce swelling, and support healing.

Pharmacotherapy

Beyond NSAIDs, antibiotics or anti-infective medication may be prescribed for testicular pain caused by bacterial infection. Anticonvulsants and antidepressants can also be used to treat nerve-related pain.

Radiofrequency ablation of the sensitised nerve

When medication isn’t enough to control neuropathic testicular pain, desensitising the surrounding nerve plexus may help. This involves specialised injections that apply micro-electrical current and heat to the affected nerves, aiming to relieve pain without causing further nerve damage.

Spinal cord stimulation

For pain that is difficult to control, spinal cord stimulation may help modulate pain signals. Electrodes are implanted near the affected nerve plexus, close to the tailbone, to interrupt pain transmission.

Surgical Treatment Options

Surgery for testicular pain is usually reserved for emergencies, such as testicular cancer or testicular torsion. Depending on the cause, this may include:

Hernia repair surgery

Needed if an intestinal hernia cannot be pushed back into the abdomen, or needs to be made smaller.

Testicular detorsion

Untwists the spermatic cord to restore blood flow to the testicle. Stitches are placed around the testicle to help prevent it from twisting again.

Testicular cancer surgery

Involves removal of the testes, which are then examined to determine the type of cancer and whether further treatment, such as chemotherapy or hormonal therapy, is needed.

How Can I Prevent Testicular Pain?

  • Go for regular check-ups
  • Wear an athletic cup during full-contact sports
  • Wear protective clothing for higher-risk tasks or jobs

A Message About Testicular Pain From Our Pain Specialist

Many men find it awkward or embarrassing to talk about testicular pain, and it’s common to dismiss a dull ache as nothing worth mentioning. Left unaddressed, it can develop into something more serious. Testicular pain that isn’t distressing but persists for more than a month should still be checked by a doctor, to rule out more serious causes such as cancer or infection. On the other end of the spectrum, less serious conditions like a hydrocele (a cyst-like swelling behind the testes) can also cause persistent testicular pain.

Persistent testicular pain is more common than many men realise. Chronic testicular pain, also called chronic orchialgia, is estimated to account for around 2.5% to 5% of all urology consultations internationally.3 Testicular pain can also follow an infection or a surgical procedure. Prostate infections and some urinary tract infections, including those following prostate surgery, can present as nerve-type pain. Research also shows that around 1% to 15% of men experience chronic pain after a vasectomy, and 3% to 6% after inguinal hernia repair.4 This type of pain happens when the nerves become irritated or hypersensitised by the earlier condition or procedure. Because the original condition has already resolved, treating it again won’t relieve this type of pain. The focus instead shifts to calming and stabilising the sensitised nerve.

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Frequently Asked Questions 

It varies by cause. A sudden injury tends to cause a sharp, immediate pain that settles into a dull ache. Some causes, such as kidney stones, produce referred pain that is felt as a sharp back pain spreading to the testicles and penis.

Acute testicular pain is sudden and short-lived, often starting as a sharp pain after an injury before settling into a dull ache. Chronic testicular pain develops gradually and lasts much longer, sometimes worsening with activity or over time. Both types can affect males of any age, and either can point to an underlying cause that needs medical attention.

Not always. Some causes are minor, such as a hydrocele, a harmless cyst-like swelling behind the testes. Others fall into three types: ischemic (poor blood supply), inflammatory, or nerve-related pain, commonly linked to epididymitis, testicular torsion, or inguinal hernia. Pain that isn’t distressing but lasts more than a month should still be checked, to rule out serious causes such as cancer or infection.

See a doctor if pain persists for more than a month, even if it isn’t severe, to rule out serious causes such as cancer or infection. Sudden, severe pain may signal an emergency such as testicular torsion and needs prompt medical attention.

Not usually. Most testicular pain is managed first with non-surgical treatment, such as anti-inflammatory medication, pharmacotherapy, radiofrequency ablation, or spinal cord stimulation, once the cause has been identified. Surgery is generally reserved for emergencies, including testicular torsion or testicular cancer, or for conditions such as an inguinal hernia that requires repair.

It’s more common than many men expect. International studies estimate chronic testicular pain accounts for about 2.5% to 5% of all urology consultations,3 and epididymitis alone is diagnosed in roughly 25 to 65 per 10,000 adult men each year.1 These figures come from overseas population studies rather than Singapore-specific data.

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Updated on July 2026