Testicular pain, or orchialgia, is typically caused by some kind of trauma. Some other causes of testicular pain include infection, and inflammation. Testicular torsion is a traumatic condition in which the testicle twists inside of the scrotum, cutting off the blood supply. This is a medical emergency, and typically requires surgical intervention. Trauma can also cause testicular rupture. Some symptoms of testicular torsion or testicular rupture include sudden, severe pain as well as redness and swelling of the scrotum.

A common infection of the testicles is called epididymitits, an infection or inflammation of the epididymis. This condition is frequently caused by sexually transmitted disease, including chlamydia or gonorrhea. Epididymitis in older men may be related to an enlarged prostate. This condition usually results in a gradual onset of pain, including redness and swelling of the scrotum. Some other symptoms associated with epididymitis are nausea, vomiting, fever, painful urination, and painful intercourse. The typical treatment for this condition is antibiotics.

Orchitis is an inflammation of the testicle. Orchitis may be caused by epididymitis that has gone untreated. Symptoms of orchitis are similar to epididymitis, and are typically treated with pain medications, antibiotics, and ice. Occasionally orchitis needs to be surgically drained.

Another type of inflammation in the testicular region is an inguinal hernia. An inguinal hernia occurs when a loop of bowel protrudes into the scrotum through a weakened part of the abdominal muscles, and is typically treated by surgical intervention. Symptoms include pain and bulging in the groin and scrotum especially during heavy lifting activities. If the intestine becomes trapped, or strangulated it will require immediate medical attention.

Treatment

When testicular pain has been present for three or more months, it is considered chronic orchialgia. Chronic orchialgia may be treated with medications, acupuncture, biofeedback, physical therapy and muscle relaxation techniques, nerve blocks, and spinal cord stimulation. Common types of medications used to treat pelvic pain include anti-inflammatories, anti-depressants, neuropathic medications, and occasionally opioids.

• For male pelvic pain that does not respond to more conservative treatment modalities, a spinal cord stimulator (typically with sacral leads) may be beneficial. Spinal Cord Stimulation (SCS) is when a small electrical pulse generator is implanted under the skin. A low-voltage electrical current is administered and decreases the perception of pain by confusing the spinal cord and brain pain processing centers. This is done on a trial basis.

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References

• Bennett, D. (2005). Interventional Approaches to Pain Management. Retrieved on February 17, 2010 from: cme.medscape.com/viewarticle/502018

• E-medicinehealth (2010). Testicular Pain. Retrieved on February 23, 2010 from www.emedicinehealth.com/testicular_pain

• McJunkin, T., Wuollet, A., and P. Lynch (2009). Sacral Nerve Stimulation as a Treatment Modality for Intractable Neuropathic Testicular Pain. Pain Physician 209; 12:991-995.

• National Guideline Clearinghouse (2008). General Treatment of Chronic Pelvic Pain. In: Guidelines on Chronic Pelvic Pain. Retrieved on February 23, 2010 from: