What You Need To Know About Lower Back And Testicle Pain

Developing lower back and testicle pain can be a condition that requires emergency medical treatment. Your pain may be caused by an infection, cancer, spinal issues, or one of several other underlying conditions. A correct diagnosis of your condition can ensure that you get the treatment you need and help relieve the mental burden of dealing with lower back and testicle pain without knowing the cause.

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What are some of the most common causes of lower back and testicle pain?


Epididymitis is an inflammation of the epididymis, the coiled tubing at the back of the testicle that stores and carries sperm. The condition is the most common cause of severe testicular pain in the US, affecting over 600,000 men annually. Epididymitis affects men of all ages but is most common among males between 14 and 35.¹

The most common cause of epididymitis is a bacterial infection, including sexually transmitted diseases like gonorrhea or chlamydia. However, epididymitis can also result from infections caused by bacteria such as E. coli or the mumps virus. The condition can also occur if urine is forced backward into the epididymis due to heavy exertion.

Epididymitis can also be caused by:

  • A blocked urethra

  • An enlarged or infected prostate gland

  • Use of a catheter

  • Traumatic groin injury

Symptoms of epididymitis typically include pain and swelling of the testicles, which start as mild but become increasingly intense and sharp. Some may experience pain when urinating, blood in the semen, or fever or chills due to the condition.

The most common treatment for epididymitis is a one or two-week course of antibiotics. While you may begin to experience relief within two or three days of beginning treatment, it's essential to continue taking the entire course of antibiotics to ensure that the infection is gone. If the bacterial infection is sexually transmitted, your partner will also need treatment.

Discomfort may also be relieved by:

  • Resting

  • Supporting the scrotum

  • Applying ice packs

  • Drinking fluids

  • Taking pain medication

Kidney stones

A kidney stone is a hard deposit of minerals and salt that can form in the kidneys. Kidney stones can be as small as a grain of sand and may not cause any issues if they stay in the kidney. However, if a stone moves into the ureter, it can block the flow of urine, increasing pressure and swelling of the kidney.

The blockage, increased pressure, and swelling can lead to excruciating pain, usually located in the lower back — one of the classic symptoms of kidney stones. The pain typically occurs in intermittent waves and radiates towards the front of the abdomen, causing scrotal and testicular pain in males. Other symptoms may include:

  • Difficulty urinating

  • Painful urination

  • Sweating

  • Nausea

  • Vomiting

Different types of stones have different causes. However, dehydration from strenuous exercise without replenishing with fluids or reduced fluid intake overall increases the risk of kidney stones. Stones may also form from elevated uric acid levels in the blood, obstructions to urine flow, and certain urinary tract infections. Other metabolic conditions and certain medications can also increase the risk.

Kidney stone treatments vary depending on the size of the stone, what it's made of, and whether it is blocking your urinary tract or causing pain. Often, your doctor will perform various tests, including a urine test, a blood test, and x-rays or CT scans to determine the best treatment.

If your test results show that the stone is small, your doctor may recommend taking pain medicine and drinking plenty of fluids to help push the stone through your urinary tract naturally. If the stone is large or blocking your urinary tract, several treatment options are available.

Extracorporeal shock wave lithotripsy is a treatment that uses shock waves to break the kidney stone into smaller pieces. Once broken up, the smaller pieces will pass through your urinary tract and out of your body with your urine. The treatment usually takes 45 minutes to an hour and can be performed under general anesthesia, meaning you are asleep and won’t feel pain.

Ureteroscopy is also performed under general anesthesia and is a procedure where the doctor uses a long, tube-shaped tool to locate the stone. In the case of a small stone, the doctor may remove it, or it is larger, they will break it up. In the case of a larger stone, a laser is used to break the stone into pieces small enough to pass through the urinary tract.

Percutaneous nephrolithotomy is a standard surgical procedure used for larger stones. During this procedure, the stone is removed by inserting a tube directly into the kidney. Because of the invasiveness of this procedure, it usually requires a hospital stay of two to three days to recover.

Urinary tract infection

Urinary tract infections (UTIs) involve the body parts that make urine and carry it out of your body. For men, these parts include the kidneys, ureters, bladder, and urethra. A build-up of bacteria anywhere in your urinary tract can lead to an infection.

UTIs are usually classified by their location in the urinary tract:

Lower tract infections include infection of the urethra or infection of the bladder. The most common cause of a lower UTI is intestinal bacteria, which contaminates the urinary tract by spreading from the skin to the urethra and then to the bladder. Inflammation of the urethra can also be caused by sexually transmitted microorganisms such as gonorrhea and chlamydia.

Upper tract infections involve the ureters and kidneys and include kidney infections. Upper tract infections occur when bacteria travel upward in the urinary tract from the bladder to the kidney or when bacteria in the bloodstream collect in the kidney.

UTIs are relatively rare in men but are a common cause of lower back and testicle pain. Sometimes, there are no signs or only mild symptoms of a UTI, but when they are present, they may include:

  • Urine with a strong odor

  • A near-constant urge to urinate

  • A burning sensation when urinating

  • Frequently passing small amounts of urine

  • Urine that is cloudy or discolored with blood

Doctors usually treat a UTI with antibiotics, chosen based on the location of the infection and the type of bacteria believed to be the cause. Typically, a week of antibiotics will clear up a lower UTI, while an upper-tract infection may require two weeks of treatment.

What are some of the less common causes of lower back and testicle pain?

Testicular cancer

While relatively rare, testicular cancer is the most common cancer found in men aged 20 to 35.² Men who have experienced abnormal testicle development, have had an undescended testicle, or have a family history of cancer are at the most significant risk.

While the cause of testicular cancer is not clear, like other cancers, it occurs when healthy cells in a testicle become altered. When cells develop abnormally, these cancer cells can accumulate and form a mass in the testicle.

Often, the first sign of testicular cancer is a lump on the testicle or a swollen testicle. The growth may also be tender and painful, with pain radiating to the lower back. Some men also experience enlargement or tenderness of the breasts.

Treatments for testicular cancer are highly successful, even if cancer has spread beyond the testicles. Radiation therapy and chemotherapy have both been shown to be effective options to kill testicular cancer cells. Surgery to remove the affected testicle and associated lymph nodes is also a common recommendation.

Lumbosacral spondylolisthesis

Lumbosacral spondylolisthesis is caused by a vertebra in the lower back slipping out of place and onto the one below. The condition puts pressure on the surrounding nerves and produces various symptoms.

Symptoms may include weakness of the legs when walking and standing and numbness or a tingling sensation in the back, buttocks, or legs. The condition may also cause a stiff and tender feeling in the back and lower back pain that may radiate into the legs and testicles.

The condition can result from an injury, repetitive strain on the spine, or general wear and tear as a person gets older. Lumbosacral spondylolisthesis is most common among young athletes in sports that stretch the lumbar spine, such as baseball, football, wrestling, weightlifting, gymnastics, and dancing.

The vertebral slippage that causes lumbosacral spondylolisthesis often occurs during growth spurts in childhood or adolescence and is one of the most common causes of back pain in teens.

Lumbosacral spondylolisthesis is typically treated with anti-inflammatory medications to reduce pain and swelling. The condition can also be treated with physical therapy to strengthen the lower back muscles. In addition, doctors may prescribe steroid injections for people with severe symptoms, and while rare, a surgical solution is sometimes required.

Spinal nerve compression

Spinal problems are a commonly overlooked cause of lower back and testicular pain in men. Often, this condition is caused by osteoarthritis, which occurs due to the gradual wear and tear of the spine's bones with age. Spinal nerve compression can occur anywhere along your spine and is caused by pressure exerted on the spinal cord. Spinal nerve compression can also be caused by:

  • An injury to the spine

  • Scoliosis

  • Spinal tumor

  • Certain bone diseases

  • Infection

The symptoms of spinal nerve compression often resemble those of many nerve-related conditions and require an expert opinion to receive the appropriate treatment. Usually, your doctor will recommend a consultation with a neurologist, a doctor who specializes in diagnosing and treating conditions that involve the nervous system.

Spinal nerve compression can cause several symptoms, including:

  • Difficulty controlling bladder or bowel functions

  • Inability to achieve or maintain an erection

  • Muscle weakness or stiffness in the arms and legs, or especially in the neck

  • Numbness, tingling, or other abnormal sensation 

  • Discomfort along the spine or the extremities, including burning or radiating pain that extends to the lower back and testicles

The treatment of spinal nerve compression depends on the location and severity of the symptoms. Typically, the first course of action is physical therapy to strengthen the muscles of your back, abdomen, and legs. Also, physical therapy will help you learn how to perform activities safely and maintain a good posture. In some cases, back braces or assistive devices may be helpful to maintain proper spine alignment.

When should you see a doctor?

It's not uncommon to experience occasional back pain. Typically, the pain may last for a few hours or a day or two and subsides. However, when the pain persists or worsens even after using self-care treatments, it can be a sign of a more severe injury or condition.

With some conditions, lower back pain can spread to other areas of the body, including the groin and testicles. The testicles are extremely sensitive, and even a minor injury or irritation can cause pain and discomfort. While there are several direct causes of testicular pain, such as blows or injuries to the groin area, many other conditions can cause lower back and testicle pain.

Men experiencing lower back and testicle pain should consult a doctor if the pain doesn't go away or is severe enough to interfere with their daily lives. It's also vital to seek medical attention if the pain occurs along with other symptoms, such as:

  • Pain or difficulty urinating

  • Fever or chills

  • Nausea or vomiting

  • Severe pain in the lower back, abdomen, or groin area

  • Blood in the urine

  • Lump on the testicle

  • Swelling of the testicle 

The lowdown

A variety of conditions can cause lower back and testicle pain, but most cases can be treated successfully. If you are experiencing lower back and testicle pain, your condition may result from an injury, infection, or illness with symptoms ranging from mild to severe. Whatever the cause, lower back and testicle pain can indicate a serious medical condition, and you receive a medical evaluation and appropriate treatment.

  1. Epididymitis | NCBI Bookshelf

  2. Testicle Cancer | NCBI Bookshelf

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