Why You Have Chronic Right Testicular Pain

Feeling persistent pain in your right testicle can be both uncomfortable and concerning. While occasional discomfort may be harmless, ongoing pain lasting several weeks or months often signals an underlying condition that requires medical attention.

Chronic testicular pain, also known as chronic orchialgia, refers to constant or recurrent discomfort in one or both testicles for at least three months. It can interfere with your ability to focus, move comfortably, or enjoy daily life.

This article explains the possible causes of chronic right testicular pain, its symptoms, diagnosis, and treatment options — helping you understand when to seek medical care.

What Is Chronic Testicular Pain?

Chronic testicular pain is defined as persistent or intermittent pain in the scrotum or testicles lasting for three months or longer. The pain can range from a mild ache to sharp, stabbing sensations.

It may be localized to one side, such as the right testicle, or affect both. The discomfort can also radiate to nearby areas, including the groin, lower abdomen, or inner thigh.

Although it can be distressing, most cases of chronic testicular pain are not linked to cancer or life-threatening conditions. However, it’s important to identify the cause early to prevent worsening symptoms.

Why You May Have Chronic Right Testicular Pain

Right-sided testicular pain can result from a wide range of causes, including infections, nerve compression, or referred pain from nearby organs. Let’s explore the most common ones.

1. Epididymitis

Epididymitis is inflammation of the epididymis — a coiled tube located behind each testicle that stores sperm. It’s one of the most frequent causes of chronic testicular pain.

The condition is usually caused by bacterial infections, including sexually transmitted infections (STIs) such as chlamydia and gonorrhea. In non-sexually active men, urinary tract bacteria are more often responsible.

Symptoms include:

• Pain and tenderness in one testicle (often the right)
  

• Swelling or redness of the scrotum
  

• Pain that worsens during movement or urination
  

If left untreated, the inflammation can become chronic, leading to ongoing discomfort.

2. Varicocele

A varicocele is an enlargement of the veins inside the scrotum. While it’s more common on the left side, some men experience it on the right.

The pooling of blood in these veins increases scrotal temperature and pressure, causing dull, aching pain that worsens after standing or physical exertion.

Common signs:

• Heaviness or dragging sensation
  

• Visible or palpable enlarged veins (“bag of worms” feel)
  

• Pain that improves when lying down
  
  

3. Inguinal Hernia

An inguinal hernia occurs when part of the intestine pushes through a weak area in the abdominal wall near the groin. If the hernia extends downward, it can cause pain or pressure in the right testicle.

Key indicators:

• Bulge in the groin or scrotum
  

• Discomfort when coughing, bending, or lifting
  

• Dull, persistent ache in the testicular area
  
  

Hernias require medical attention to prevent complications like strangulation, where blood flow to the intestine is cut off.

4. Nerve Compression or Irritation

The nerves supplying the testicles originate in the lower back and pelvis. Compression of these nerves — due to spinal issues, muscle tension, or scar tissue — can cause referred pain in one testicle.

This type of pain is often described as burning, tingling, or radiating to nearby areas. It may worsen with certain postures, prolonged sitting, or heavy lifting.

5. Post-Surgical or Post-Vasectomy Pain

Some men develop chronic testicular pain following procedures such as vasectomy, hernia repair, or hydrocele removal. This can occur due to nerve injury, scarring, or inflammation during the healing process.

If your pain started after surgery, your doctor may recommend nerve-targeted therapies or microsurgical denervation to relieve symptoms.

6. Chronic Prostatitis or Pelvic Floor Dysfunction

Chronic prostatitis — inflammation of the prostate gland — is a common cause of radiating pain to the testicles. Similarly, tight pelvic floor muscles can put pressure on nerves and blood vessels, leading to chronic right-sided discomfort.

Accompanying symptoms may include:

• Pain during urination or ejaculation
  

• Lower abdominal or perineal discomfort
  

• Urinary frequency or urgency
  

Pelvic floor therapy and anti-inflammatory treatments are often effective in such cases.

7. Testicular Torsion (Intermittent)

Although acute testicular torsion is a medical emergency, intermittent torsion can cause recurring pain that resolves on its own. It happens when the spermatic cord twists temporarily, cutting off blood supply before untwisting again.

This can result in sharp, sudden pain episodes in the right testicle that come and go unpredictably. If untreated, full torsion can occur — requiring emergency surgery to save the testicle.

8. Referred Pain from the Kidney or Spine

Sometimes, the pain you feel in your testicle isn’t coming from the testicle itself. Kidney stones, spinal nerve compression, or lower back disorders can refer pain to the groin and scrotum.

If your pain is accompanied by flank discomfort, blood in urine, or lower back stiffness, your doctor may investigate your urinary tract or spine.

Symptoms to Watch For

The exact symptoms depend on the underlying cause, but typical signs of chronic testicular pain include:

• Dull ache or sharp pain in the right testicle
  

• Heaviness or swelling in the scrotum
  

• Pain radiating to the groin, thigh, or abdomen
  

• Discomfort during urination or sexual activity
  

• Sensitivity when sitting or standing for long periods
  
  

If your pain is severe, sudden, or associated with nausea, fever, or swelling, seek emergency medical help — it could indicate torsion or infection.

How Chronic Right Testicular Pain Is Diagnosed

A urologist will conduct a thorough assessment to determine the cause of your pain.

1. Medical History and Physical Exam

You’ll be asked about the duration, severity, and location of the pain. The doctor will examine the testicles, groin, and abdomen for swelling, lumps, or tenderness.

2. Laboratory Tests

Urine and semen analysis help detect infections or inflammation. STI testing may also be done if necessary.

3. Imaging Tests

• Scrotal ultrasound: The most reliable test to check for blood flow issues, cysts, or varicoceles.
  

• CT or MRI: Used if the pain might be related to nerve compression or spinal problems.
  
  

4. Diagnostic Nerve Block

If nerve irritation is suspected, a small amount of anesthetic may be injected into the spermatic cord. Relief following the injection confirms nerve involvement.

Treatment Options for Chronic Testicular Pain

Treatment depends on the root cause and may include medication, therapy, or minor surgical procedures.

1. Medications

• Antibiotics: For bacterial infections like epididymitis or prostatitis.
  

• NSAIDs: Reduce inflammation and relieve discomfort.
  

• Neuropathic pain medications: Such as gabapentin or amitriptyline for nerve-related pain.
  
  

2. Physical Therapy

Pelvic floor therapy can help relax tight muscles and improve blood flow. Gentle stretching and posture correction can ease nerve compression.

3. Nerve Block or Injections

A spermatic cord block can provide long-term relief for nerve-related pain. It’s minimally invasive and often performed under local anesthesia.

4. Surgery

If conservative methods fail, surgical options include:

• Microsurgical denervation: Removes the small nerve fibers responsible for pain.
  

• Varicocelectomy: Treats varicoceles to restore normal blood flow.
  

• Hernia repair: Fixes abdominal wall weaknesses causing referred pain.
  
  

5. Lifestyle Adjustments

• Wear supportive underwear.
  

• Avoid heavy lifting and long hours of sitting.
  

• Stay hydrated and maintain good posture.
  

• Manage stress with meditation or breathing exercises.
  
  

6. Counseling and Pain Management

Living with chronic testicular pain can impact your mental health. Working with a pain specialist or therapist can help you develop coping strategies and reduce anxiety.

When to See a Doctor

Seek immediate medical attention if you notice:

• Sudden or severe testicular pain
  

• Swelling, redness, or warmth in the scrotum
  

• Fever, nausea, or vomiting
  

• A lump or abnormal growth in the testicle
  

• Pain that lasts beyond a few weeks
  
  

Early diagnosis not only prevents complications but also improves treatment outcomes.

Conclusion

Chronic testicular pain—especially on one side like the right—can stem from many causes, including infections, hernias, nerve issues, or referred pain. While it’s rarely dangerous, ignoring it can delay recovery and affect your quality of life.

With proper diagnosis and treatment, most men experience significant relief. If your right testicular pain has lasted longer than a few weeks, don’t hesitate to consult a urologist. Early care can help restore comfort, confidence, and peace of mind.

FAQs

1. What causes chronic right testicular pain?

It can result from infection, varicocele, nerve compression, hernia, or post-surgical complications.

2. Is chronic testicular pain serious?

Usually not, but persistent pain indicates an underlying issue that should be evaluated by a urologist.

3. Can stress cause testicular pain?

Yes. Stress can tighten pelvic muscles and amplify nerve sensitivity, contributing to pain.

4. How long does chronic testicular pain last?

By definition, it lasts three months or longer, though duration depends on the underlying cause and treatment.

5. Can sitting for long hours cause testicular pain?

Yes. Prolonged sitting increases pressure on the scrotum and can irritate nerves.

6. How is chronic testicular pain diagnosed?

Through physical examination, imaging (ultrasound), lab tests, and sometimes diagnostic nerve blocks.

7. What treatments are available?

Treatment includes antibiotics, anti-inflammatory medication, nerve blocks, physical therapy, or surgery.

8. Can chronic testicular pain affect fertility?

Yes, if the pain is due to conditions like varicocele or infection. Early treatment helps protect fertility.

9. When should I see a urologist?

If your pain lasts more than two weeks, worsens, or is associated with swelling, fever, or urinary symptoms.

10. Can chronic testicular pain go away on its own?

Sometimes, but most persistent pain requires medical evaluation to rule out serious causes.