Testicular Pain
Are you experiencing a sharp sudden pain OR chronic pain in the testicular region? I’ve got you covered!
Chronic testicular pain is defined as intermittent or constant testicular/scrotal pain lasting greater than 3 months and interfering with daily life. Clinical estimates approximate that about 100,00 men per year in the United States are affected by testicular pain. It roughly accounts for 2.5%-5% of urology consultations. Think about how many cases that are mild or going untreated because men are not seeking professional help.
As a pelvic floor physical therapist, we are looking at testicular pain with a musculoskeletal lens today. Needless to say, there are red flags to be aware of when experiencing testicular pain.
⚠️ Seek urgent care if:
Sudden severe pain (possible torsion)
Swelling, redness, fever (infection)
Nausea/vomiting with severe pain
Trauma
If you have had consistent pain with no red flags, it is time to start thinking about the musculoskeletal system. Let’s start with a little developmental basics. The testes originate in the upper abdomen during fetal development and descend through the inguinal canal into the scrotum. Due to the path of descent, they carry abdominal layers with them.
Transversalis fascia → internal spermatic fascia
Internal oblique → cremaster muscle/fascia
External oblique aponeurosis → external spermatic fascia
Besides just the origin of the testes, there are several fascial lines connecting the abdomen to groin. Dysfunction in the deep frontal line may refer pain into the testicles. Some of the biggest structures with known connections are psoas major, internal/external obliques, transverse abdominis, and of course, the pelvic floor itself.
Looking at the course of the genitofemoral nerve is also important when evaluating testicular pain. The genitofemoral nerve emerges from L1–L2, travels through the psoas, splits into genital + femoral branches, and the genital branch runs through the inguinal canal to the scrotum. So, hypertonicity in the psoas, trigger points in the iliacus, and fascial restrictions can cause irritation or hypersensitivity to the genitofemoral nerve. This is often perceived as unilateral testicular pain.
This is especially common in:
Runners
Prolonged sitters
Post-hernia repair
Heavy lifters
Due to the relationship between the abdomen and testicles, different techniques can be used in treatment methods. Here are a few of the different treatment approaches we use:
Deep abdominal work, including peritoneum mobilizations, can help release some of the restricted soft tissue in the deep layers of the abdomen.
Dry needling to the hip flexors (psoas major) can help with trigger point release, restoring blood flow to muscles, and relieving irritation to the genitofemoral nerve.
Cupping along the fascial lines is another method used to help improve blood flow, improve mobility, and enhance fascial glides.
Exercises to help decrease tension in the pelvic floor muscle and improve overall pelvic mobility. A few examples include: child's pose, happy baby, and deep squat.
So what’s next?
Testicular pain may be common, but is not normal. It is also something you do not have to live with forever!
And if you’re local to East Texas and wanting to schedule an appointment, good news! We see male patients and are accepting new patients at all 3 of our locations: Sulphur Springs, Rockwall, and Canton.
To schedule an appointment, call 903-962-2600 or request an appointment by filling a form here and someone from our office will reach out to get you on the schedule.
Next on your reading list:
Pelvic Floor Physical Therapy for Erectile Dysfunction
The Function of the Male Pelvic Floor