Testicle Pain: Causes and When It Is an Emergency
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 5 November 2026
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Sudden, severe testicle pain is an emergency. It may be testicular torsion, which needs surgery within hours to save the testicle. Go to A&E or call 112 straight away. Milder pain, or pain that comes and goes, is more often an infection (epididymitis), an injury, a hernia or swollen veins. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).
- Sudden, severe pain in one testicle, with or without vomiting: A&E or 112 now.
- Torsion is most common between 12 and 18, but it can happen at any age.
- Epididymitis causes pain that builds over hours or days, often with fever or pain when peeing.
- A varicocele causes a dull ache and can feel like a "bag of worms".
- A lump that does not hurt still needs checking: testicular cancer is usually painless.
What causes testicle pain?
The pain can come from the testicle, the tube behind it (the epididymis), the scrotum, or from higher up, such as the groin or kidney. The most common causes are:
- Testicular torsion: the testicle twists and cuts off its blood supply. This is an emergency.
- Torsion of a small appendage: a tiny bit of tissue twists. It is common in boys and hurts in one spot.
- Epididymitis or orchitis: an infection. Under 35 it is often sexually transmitted; over 35 it often comes from a urine infection. Mumps can also cause orchitis.
- An injury: from sport or a fall.
- An inguinal hernia: a bulge in the groin that can drop into the scrotum.
- A kidney stone: the pain can spread down to the testicle.
- Varicocele, hydrocele or cysts: these usually cause a dull ache or heaviness.
How do I know if it is testicular torsion?
- Sudden, severe pain in one testicle, sometimes during sleep or after sport.
- Feeling sick or being sick.
- The testicle sits higher than normal or lies sideways.
- The scrotum is swollen and red.
- Pain low in the tummy, especially in boys.
If it could be torsion, do not wait for an appointment or a video call. MedlinePlus says most testicles can be saved if surgery happens within the first 6 hours.
What is epididymitis?
It is swelling of the epididymis, nearly always from an infection. The pain and swelling build over hours or days, not all at once. You may have a fever, stinging when you pee or a discharge. It needs a doctor and often antibiotics, which are prescription-only in Spain, the UK and the US. If the cause is sexually transmitted, your partner needs treatment too.
What is a varicocele?
It is swollen veins in the scrotum, mostly on the left side. It causes a dull ache or heaviness that is worse when you stand or at the end of the day. It can feel like a "bag of worms". It is usually harmless, but a doctor should check it.
What if I feel a lump?
A hard lump in the testicle, even if it does not hurt, should be checked soon. Testicular cancer is most common between 15 and 49, and it can nearly always be cured if treated early. Check yourself once a month, after a warm shower.
What can I do if the pain is mild?
- Wear snug, supportive underwear.
- Use a cold pack wrapped in a towel.
- For pain you can take paracetamol or ibuprofen, following the leaflet.
- See a doctor if it is not better in a day or two.
Useful Spanish words: dolor de testículos (testicle pain), torsión testicular (torsion), epididimitis and urgencias (A&E).
When should I go to A&E or call 112?
- Sudden, severe pain in one testicle.
- Pain with feeling sick or being sick.
- A testicle that sits higher or at an odd angle.
- A lot of swelling after an injury.
- Pain with a high fever and feeling very unwell.
Frequently asked questions about testicle pain
Can adults get testicular torsion?
Yes. It is most common in teenagers, but it can happen at any age, including babies and adults.
Can testicle pain come from the kidney?
Yes. A stone in the kidney or the tube below it can cause pain that spreads to the groin and testicle.
Is it normal for one testicle to hang lower?
Yes, that is normal. What is not normal is a sudden change in position with pain.
Do I need an ultrasound?
Often, yes, to check the blood flow and the cause. If torsion is suspected, surgery should not wait for a scan.
Can testicle pain be checked by video?
Mild aches that have lasted days can be discussed by video. Sudden, severe pain cannot: go to A&E or call 112.
Getting a medical assessment
If you are in Spain and you have a mild testicle ache that has lasted a few days, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. If the pain is sudden, go to A&E. You can also read about sexual health, groin pain and kidney stones. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.
Sources
This content is written and reviewed by a licensed physician with reference to the following sources.
