Lower Back and Testicle Pain: A Guide to Causes and When to Seek Help

Experiencing pain in two distinct areas like the lower back and a testicle can be confusing and alarming. However, these two symptoms are often connected through a complex network of nerves and shared anatomical pathways. Understanding the potential causes is the first step toward getting the right diagnosis and treatment.

This comprehensive guide synthesizes information from leading health authorities to explain the link between lower back and testicle pain, outline the possible causes from common to critical, and clarify when you must seek medical attention.

Understanding the Connection: How Back Problems Cause Testicle Pain

The primary reason you might feel testicular pain from a back issue is referred pain. Nerves that provide sensation to your groin and testicles originate in the thoracic (mid-back) and lumbar (lower-back) regions of your spine. When a problem in your spine—like a herniated disc or arthritis—compresses or irritates these nerves, your brain interprets the pain signal as coming from the testicle, even though the testicle itself is healthy.

!Medical illustration showing the nerve pathways from the lumbar spine to the groin and testicular area. Anatomical illustration of nerve pathways. Image for conceptual purposes.

Common Causes of Combined Lower Back and Testicle Pain

The causes can be broadly categorized into issues originating from the spine (neurological/orthopedic) and those originating in the urogenital system (urological).

Spinal and Nerve-Related Issues

Spinal problems are a frequently overlooked source of testicular pain. According to medical experts at Spine-health, these conditions can directly lead to referred pain.

Nerve Compression

• Herniated Disc: When one of the cushioning discs between your vertebrae bulges or ruptures, it can press on nerves from the T10 to L2 spinal levels, causing pain and tingling that radiates to the testicle on the same side.
• Lumbar Spondylolisthesis: This condition occurs when a vertebra in the lower back slips out of place, putting pressure on spinal nerves. This can cause persistent lower back pain that travels down to the testicles and legs.
• Facet Joint Osteoarthritis: Degeneration of the small joints in the spine can create bone spurs that narrow the space for nerves. If the L1 spinal nerve is affected, it can cause pain in the testicle.
• Sacroiliac (SI) Joint Dysfunction: Problems with the joint connecting your spine to your pelvis can compress sacral nerves (S2-S4), leading to pain felt in the scrotum.

Urological and Infectious Conditions

These conditions directly affect the urinary tract or reproductive organs, and the resulting pain can often radiate to the lower back.

Infections and Inflammation

• Epididymitis and Orchitis: Epididymitis, an inflammation of the tube at the back of the testicle (epididymis), is a leading cause of testicular pain. It's often due to a bacterial infection, including STIs. Orchitis is inflammation of the testicle itself. Both can cause significant pain that, as noted by Medical News Today, can radiate to the groin and lower back.
• Urinary Tract Infections (UTIs): A UTI can cause pelvic pain and a burning sensation during urination. If the infection travels to the kidneys, it can cause severe pain in the back and sides, along with fever and nausea.
• Kidney Stones: Hard mineral deposits forming in the kidneys can cause excruciating, sharp pain that starts in the lower back and radiates down to the groin and testicles as the stone moves through the urinary tract.

Other Urological Causes

• Inguinal Hernia: This occurs when tissue, such as part of the intestine, pushes through a weak spot in the abdominal muscles near the groin, causing a bulge and pain that can be felt in the testicle and lower back.
• Varicocele: An enlargement of the veins within the scrotum, similar to a varicose vein in the leg. It can cause a dull, aching pain or a feeling of heaviness.
• Diabetic Neuropathy: As explained by Healthline, nerve damage from high blood sugar can cause pain, numbness, and tingling in various parts of the body, including the back and pelvic region.

When to See a Doctor: Distinguishing an Emergency from a Chronic Issue

Not all pain is created equal. It is critical to differentiate between symptoms that require an immediate trip to the emergency room and those that can be addressed in a scheduled doctor's visit.

Red Flags: Seek Immediate Medical Attention

The term "acute scrotum" refers to a rapid onset of scrotal pain and is treated as a surgical emergency until proven otherwise. Seek immediate help if you experience:

• Sudden and severe testicular pain, especially on one side. This is the hallmark symptom of Testicular Torsion.
• Testicular Torsion: This is a medical emergency where the spermatic cord twists, cutting off blood flow. It requires immediate surgery to save the testicle. The salvage rate drops dramatically after 6 hours.
• Swelling, redness, or tenderness of the scrotum.
• A testicle that appears to be riding higher than normal or is at an unusual angle.
• Nausea and vomiting accompanying the pain.
• Fever and chills.
• Blood in your urine or semen.
• Loss of bladder or bowel control, or numbness around the groin or buttocks (symptoms of Cauda Equina Syndrome, another neurological emergency).

When to Schedule a Doctor's Appointment

Contact your doctor for an appointment if you have:

• A dull, aching pain in the testicle or back that persists for more than a few days.
• An unexplained lump, firmness, or swelling in a testicle.
• A feeling of heaviness in the scrotum.
• Pain that worsens with activity but improves with rest.
• Pain that is interfering with your daily life.

!A concerned man holding his lower back, conveying the need to seek medical advice. Do not ignore persistent or severe symptoms. A medical evaluation is essential for an accurate diagnosis.

The Diagnostic Process: What to Expect

To determine the cause of your pain, your doctor will follow a systematic approach.

1. Medical History and Physical Exam: Your doctor will ask about the onset, nature, and location of your pain, along with other symptoms. A physical examination of your back, abdomen, and testicles will be performed to check for tenderness, swelling, or lumps.
2. Laboratory Tests: A urinalysis can detect signs of a UTI or blood from kidney stones. Blood tests can check for markers of infection.
3. Imaging Studies: An ultrasound is the primary tool for evaluating the testicles and can diagnose torsion, epididymitis, or tumors. If a spinal issue is suspected, your doctor may order an X-ray, CT scan, or MRI to get a detailed look at your vertebrae and nerves.

Treatment Options for Lower Back and Testicle Pain

Treatment is entirely dependent on the underlying diagnosis.

• Infections (UTI, Epididymitis): A course of antibiotics is the standard treatment.
• Spinal/Nerve Issues: Treatment may include physical therapy, anti-inflammatory medications, steroid injections, or in some cases, surgery to relieve nerve pressure.
• Kidney Stones: Small stones may pass on their own with increased fluid intake and pain medication. Larger stones may require procedures to break them up or remove them.
• Testicular Torsion: This requires immediate surgery to untwist the cord and restore blood flow.
• Testicular Cancer: Treatment depends on the type and stage but can include surgery, radiation therapy, and chemotherapy.
• Home Care: For minor strains or inflammation, your doctor may recommend rest, applying ice packs to your back, using a scrotal support (jockstrap), and taking over-the-counter pain relievers like ibuprofen.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

References

• Medical News Today - What can cause lower back and testicle pain?
• Healthline - What’s Causing My Lower Back and Testicle Pain?
• Urology of Greater Atlanta - Lower Back & Testicle Pain Causes & Symptoms
• Spine-health - 3 Causes of Back and Testicular Pain
• National Institutes of Health (NIH) - Testicular pain originating from lumbar disc degeneration
• Cleveland Clinic - Testicular Pain: Causes, Sides, Diagnosis & Treatment