9 reasons why your balls might hurt, from infections to testicular torsion, and when to get to the ER fast

• Injuries, infections, kidney stones, hernias, and testicular cancer can all cause testicular pain.
• Sometimes, pain in your balls may not have an obvious cause and will go away without treatment.

Sudden pain in your testicles can be pretty alarming, not to mention unpleasant, whether that pain is mild, moderate, or severe enough to send you to the emergency room.

Your testicles, the two ball-shaped organs behind your penis, are housed in a loose sac of skin called the scrotum. Though it might go without saying, this area of your body is fairly sensitive.

A number of things can cause pain in your testicles, including trauma, infections, and various health conditions — but knowing the cause of your pain can help you get the right treatment.

Read on for nine causes of testicular pain and what you can do to address each one.

Medical term: Your balls, also called testes, produce both testosterone and sperm.

1. Hydrocele

A hydrocele, or swelling in the scrotum caused by a buildup of fluid around the testicles, is most common in babies but can also happen in children and adults.

This condition usually doesn't involve severe symptoms or pose a major health risk, says Dr. Olufenwa Milhouse, a board-certified urologist at Amita Health Adventist Hinsdale Hospital, but it can make your scrotum feel swollen and heavy, causing a dull ache.

As an adult, you're more likely to develop a hydrocele after an injury to your scrotum, or if an infection in your testicles, like epididymitis, causes inflammation in your scrotum. But often, a hydrocele has no clear cause.

What to do next: Small to moderate hydroceles often don't cause pain and may not require treatment. That said, if the swelling doesn't improve within a week or so, or you notice increased swelling in your scrotum, you'll want to make an appointment with your doctor as soon as possible.

2. Testicular trauma

Testicular trauma, or damage caused by a severe hit or blow to the testicles, is one of the major causes of testicular pain.

Common causes of testicular trauma include:

• Kicks or punches to the testicle
• Penetration by weapons like knives
• Car, bike, or motorcycle accidents
• Animal bites

According to Dr. Gregory Quayle, a board-certified urologist and an advisory board member at Phoenix, symptoms of testicular trauma include:

• Bruised scrotum and swollen testicles
• Lower abdominal pain
• Nausea or vomiting
• Blood in your urine
• Pain while urinating

What to do next: To treat mild pain, you can apply ice to the affected area or take over-the-counter painkillers, such as ibuprofen.

That said, it's always a good idea to check in with your doctor after an injury to your testicles or scrotum. Quayle recommends visiting the hospital to have the damage checked out by a medical professional, regardless of how much pain you experience.

3. Varicocele

Varicocele is the widening of the veins inside your scrotum. These veins typically carry blood away from your testicles, but sometimes, blood can build up in your veins instead of flowing freely out of the scrotum. This causes enlarged veins, or varicocele.

Varicocele may happen due to:

• Hernias
• Abdominal or kidney tumors
• Leaking or faulty valves in the veins in your testicles
• Testicular cancer

It tends to develop over time — especially after puberty — and often involves no symptoms, especially in the early stages.

That said, you may notice the following symptoms:

• Pain in both testicles
• Infertility
• A visible mass on your scrotum that resembles a "bag of worms"
• A smaller size to the affected testicle

What to do next: If you notice any of the above symptoms, you'll want to make an appointment with a healthcare professional. A doctor can diagnose varicocele with an ultrasound or physical exam. While this condition often doesn't require treatment, they'll most likely recommend monitoring your symptoms with regular checkups.

When varicocele causes significant pain or fertility issues, your doctor may recommend surgery to redirect blood flow from the affected veins to healthy ones.

Note: Varicocele often doesn't involve obvious symptoms, so it's a good practice to schedule annual wellness checkups. Regular exams give your doctor the chance to notice early signs of varicocele, along with other health conditions.

4. Epididymitis

The epididymis, a tube located behind your testicles that helps transport and store sperm, can become swollen and inflamed due to:

• Injury or other trauma
• Bacterial infections, including bladder and prostate infections
• Sexually transmitted infections (STIs) like chlamydia and gonorrhea

This inflammation, known as epididymitis, may cause testicular pain, swelling, and infection in one or both testicles, according to Milhouse. You may also experience:

• Fever
• Painful urination
• Pain in your scrotum

Epididymitis can occur at any age, but it most often develops in people ages 14 to 35.

What to do next: If you experience severe pain in your scrotum and painful urination, it's best to seek emergency treatment. A healthcare professional can diagnose epididymitis by checking your groin and testicles for swelling. They may prescribe antibiotics such as doxycycline and ciprofloxacin to treat the condition.

At home, you can also take steps to relieve your discomfort by:

• Resting
• Applying an ice pack to the affected area
• Drinking plenty of fluids
• Taking non-steroidal anti-inflammatory medications (NSAIDs) like Ibuprofen

Just keep in mind these remedies won't treat the infection itself — without prescription antibiotics, the infection may get worse and cause permanent damage to your testicle.

5. Orchitis

Orchitis is a type of infection that causes inflammation in the testicles, Quayle says.

Usually, bacterial infections such as STIs or urinary tract infections cause orchitis, but the mumps virus may also cause this condition.

Orchitis can affect one or both testicles and may cause severe pain and infertility.

Other symptoms you might notice with orchitis include:

• Mild to severe pain in your testicles
• Swelling in one or both testicles
• Fever
• Fatigue
• Nausea and vomiting

What to do next: If you experience any of the above symptoms, get medical attention as soon as possible. Depending on the underlying cause of orchitis, your doctor may recommend antibiotics, pain relievers, or elevating your scrotum, Quale says.

Quick tip: You can elevate your scrotum by lying down and placing a folded or rolled towel between your legs.

6. Kidney stones

Kidney stones, hard mineral and salt deposits formed in your kidneys, can cause severe pain. This pain usually starts in your groin and lower abdomen, Quayle says, but you may feel it in your testicles, too.

Note: The pain you feel with kidney stones may radiate from your groin and abdomen and feel as if it's coming from your testicles — even though it doesn't affect them directly.

Kidney stones have no specific cause, but a number of factors can increase your risk of developing them. These include intestine bypass surgery, excessive vitamin D intake, and metabolic disorders such as renal tubular acidosis.

Symptoms of kidney stones include:

• Painful and excessive urination
• Red or brown urine with a foul smell
• Sharp pain in your back and sides
• Nausea and vomiting
• Fever and chills

What to do next: If you have pain in your groin and testicles, along with difficult or painful urination, make an appointment with your doctor right away. If your doctor diagnoses kidney stones, they may recommend the following, depending on the size of the stones:

• Drinking lots of water: This helps to dilute your urine to prevent new kidney stones from forming and helps you pass existing small stones.
• Taking painkillers: Over-the-counter (OTC) painkillers such as naproxen and ibuprofen can help relieve pain you might experience when passing kidney stones via urination.
• Taking alpha blockers: These medications can help relax your ureter, which connects the kidney to the bladder. This can help you pass the stones more easily. .
• Shock wave therapy: Your doctor may also recommend a common procedure called shock wave lithotripsy to help break up large kidney stones so you can pass these pieces in your urine.
• Surgery: If shock wave therapy doesn't work, your doctor may recommend surgery to remove large stones.

7. Inguinal hernia

If you notice a bulge protruding from your lower abdomen near your groin, you may have an inguinal hernia.

This bulge, which consists of tissue, usually appears on one side of your pubic bone. While hernias don't always cause pain, they may involve testicular pain and swelling if they push through into your scrotum, Quayle says.

You may experience mild to moderate pain around your groin and milder pain in your testicles, Milhouse says. You may also notice other symptoms, such as:

• A burning sensation at the bulge
• Pain in your groin when you bend, lift objects, or cough
• Weakness or pressure in your groin

Anyone can develop a hernia, but common risk factors include:

• Strenuous activities, such as lifting heavy weights
• Increased abdominal pressure, often from straining during bowel movements
• Chronic coughs and sneezes

What to do next: If you notice a bulge in your abdomen or groin, it's best to get medical attention right away.

Inguinal hernias don't go away on their own. They may get worse without treatment, which usually involves surgery. You could also develop a strangulated hernias, where the protruding tissue becomes trapped in the abdominal wall and cuts off blood flow to the tissue inside.

Strangulated hernias can be life-threatening, so it's essential to get emergency medical attention if your hernia turns dark in color or you:

• Have sudden, intense pain
• Develop a fever
• Become constipated and can't pass gas
• Experience nausea and vomiting

8. Testicular torsion

Another common cause of testicular pain is testicular torsion, which happens when your testicle twists. This condition cuts off the flow of blood to your testicle and causes sudden, severe pain. And according to Quayle, testicular torsion happens more in people under the age of 25.

According to Milhouse and Quayle, other symptoms you may experience include:

• Nausea and vomiting
• Extreme tenderness of the affected testicle
• Visible swelling of the scrotum on one side
• A lump in the affected testicle

Experts have yet to determine the cause of this severe condition, although an injury to the testicles can increase your risk. Bell clapper deformity, a condition where your testicles aren't firmly attached to your scrotum, can also cause testicular torsion.

What to do next: Testicular torsion is a medical emergency. In order to save your testicle, you'll typically need to get treatment within 6 hours of noticing the pain. If blood flow remains cut off from your testicles for over 6 hours, you may need surgery to remove the testicle.

Even with prompt treatment, however, you'll still need surgery to attach your testicles to your scrotum. Surgery will help keep your testicles from getting twisted again.

9. Testicular cancer

Testicular cancer happens when cells in your testicles multiply faster than they should and eventually clump together to form a mass. This type of cancer can develop in one or both testicles. It mostly affects people between the ages of 15 and 35, although it can occur at any age.

Symptoms of testicular cancer include:

• Pain in either testicle
• Swelling in your scrotum
• A heavy lump or swelling in one or both testicles
• Pain or ache around your groin

You have a higher chance of developing testicular cancer if:

• Your testicles did not fully descend into your scrotum at birth
• At least one of your siblings or parents had this type of cancer
• You're a non-Hispanic white American or European

What to do next: If you feel pain or heaviness in your testicles, it's best to seek immediate medical attention. Testicular cancer is highly treatable, but the specific treatment your doctor recommends will depend on a number of factors, including the stage of the cancer and your overall health. Treatment options include chemotherapy, radiation therapy, and surgery.

Insider's takeaway

Testicular pain can have a number of explanations — some more serious than others. If you experience sudden, severe pain in your testicles that lasts longer than an hour, you'll want to get medical attention right away.

When it comes to milder pain in your testicles or genitals that keeps coming back, you'll still want to make an appointment with a healthcare professional as soon as possible. They can help determine the cause of your pain and recommend the right treatment.

Keep in mind, too, that annual wellness checkups can help your doctor catch potential risk factors and early signs of underlying health conditions that may involve testicular pain. A prompt diagnosis of some conditions, like testicular torsion or cancer, may save your testicles.