What is an Chronic Testicular Pain?

Chronic testicular pain (also known as chronic orchialgia) is defined as persistent or recurrent pain in one or both testicles lasting for more than 3 months, even when there is no obvious infection, tumour, or structural abnormality. It may be constant or intermittent, and
can significantly affect quality of life.

The pain may originate from the testicle itself, or it may be referred pain from surrounding nerves, muscles, or joints — including the lower back, groin, or pelvis.

What are the symptoms?

You may experience:

  • Dull, aching, or sharp pain in one or both testicles
  • Pain that radiates to the groin, inner thigh, perineum, or lower abdomen
  • Increased sensitivity or tenderness in the scrotal area
  • Pain aggravated by sitting, physical activity, or tight clothing
  • In some cases, numbness or tingling, suggesting nerve involvement

How is it diagnosed?

Diagnosis is based on:

  • A comprehensive clinical history and physical examination
  • Identification of pain patterns, nerve involvement, or myofascial triggers
  • Review of any previous scans or urology assessments
  • Diagnostic nerve blocks may be used to confirm the participation of specific nerves

What are the common causes we assess?

At our clinic, we evaluate nerve-related and musculoskeletal causes of testicular pain, such as:

  • Genitofemoral or ilioinguinal neuralgia (nerve entrapment or irritation)
  • Obturator or pudendal nerve involvement
  • Post-surgical pain (e.g. after vasectomy, hernia repair, or varicocele treatment)
  • Referred pain from the lumbar spine, sacroiliac joints, or pelvic muscles
  • Myofascial pain syndrome involving the abdominal wall or pelvic floor muscles

We do not treat pain due to testicular torsion, infections, tumors, or urological emergencies — these conditions must be assessed urgently by a urologist or general practitioner.

 

What treatments do we offer?

We offer several targeted treatments, depending on the likely source of pain:
1. Peripheral Nerve Blocks

  • If your neck pain is accompanied by nerve-related testicular pain, we may offer blocks of the:
      o  Genitofemoral nerve
      o  Ilioinguinal nerve
      o  Pudendal nerve (if perineal pain is also present)
  • These are performed using ultrasound or anatomical guidance with local
    anaesthetic, sometimes with steroid

2. Pulsed Radiofrequency Treatment

  • If a nerve block provides temporary relief, we may consider pulsed radiofrequency,
    which modulates the nerve’s pain signals for longer-lasting relief without damaging
    the nerve

3. Trigger Point Injections

  • For myofascial or muscular causes of referred testicular pain (e.g. from abdominal
    wall, pelvic floor, or lower back muscles), we offer trigger point injections

4. Sacroiliac Joint or Lumbar Facet Injections

  • If pain is referred from the lower back or pelvis, we may offer image-guided injections to the sacroiliac joints or lumbar facet joints

Medication Optimisation

We review your current medications to ensure they are safe and effective.
In line with local prescribing guidelines, we do not prescribe opioids or pregabalin. These
should be managed by your own GP. We can offer recommendations for safer alternatives and support with reducing unnecessary medications.

 

What to expect from treatment

  • Our goal is to identify the true pain source and offer relief through targeted, minimally invasive treatments
  • All procedures are day-case, non-surgical, and tailored to your needs
  • Most patients report improvement in pain and daily function when the correct pain generator is identified and treated
  • Follow-up and repeat procedures may be considered as part of long-term management

What we do not offer

  • We do not treat acute testicular conditions, infections, or structural testicular diseases — these should be assessed by urology or your GP
  • We do not prescribe opioids or pregabalin, following local policy
  • We do not provide emergency pain services.

What to expect from treatment

  • Most people experience gradual improvement with the right combination of physical strategies and targeted interventions
  • All procedures are minimally invasive and performed as day-case treatments
  • Our goal is to help you reduce pain, restore function, and reduce reliance on medication

What we do not offer

  • We do not provide surgical interventions or spinal operations
  • We do not prescribe opioids or pregabalin, in line with local guidelines
  • We do not offer emergency care for acute neck trauma or neurological emergencies