Symptoms
Testicular pain: if it is sudden and severe, go to the ER
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Sudden, severe testicular pain
- Testicular pain with nausea or vomiting
- Swelling that lasts more than an hour after an injury
- Fever with a red, warm or very tender scrotum
- Any testicular pain in a child or teen
Help lines
Sudden, severe testicular pain is an emergency: it can be testicular torsion, which cuts off the blood supply to the testicle and needs surgery within hours. Go to the emergency room now, not to a video visit. If the pain came on slowly, is mild and there is no swelling or fever, the doctor evaluates you by video and gives you a lab order.
Other names: Testicle pain, Swollen testicle
Possible causes
Testicular torsion
Sudden, severe pain: an emergency, go to the ER now
Epididymitis from chlamydia
Pain that comes on gradually, on one side
Epididymitis from gonorrhea
Sometimes with discharge or burning when you pee
Injury
If swelling lasts more than an hour, go to the ER
Hernia or kidney stone
Pain from the groin or spreading down from the side
Hydrocele, varicocele or spermatocele
Fluid or enlarged veins in the scrotum
Testicular cancer
Almost always a painless lump; in-person evaluation
On this page(8)
Sudden, severe testicular pain: go to the ER now
Testicular torsion is when the testicle twists and its blood supply is cut off. According to MedlinePlus, it causes sudden severe pain in one testicle, swelling on one side of the scrotum, and sometimes nausea or vomiting. It is most common in the first year of life and at the start of puberty, but it can happen at any age.
It is an emergency: according to MedlinePlus, if surgery is done within the first 6 hours, most of the testicle can usually be saved, and after that the risk of losing it goes up. MedlinePlus advises going to an emergency room rather than urgent care, in case surgery is needed right away. Call 911 if you have no way to get there. See when to go to the ER.
In children and teens, any testicular pain goes to the ER. Do not wait for an appointment.
Other causes of testicular pain
According to MedlinePlus and the CDC, other causes include:
- Epididymitis: inflammation of the tube behind the testicle. The pain comes on gradually, on one side, with tenderness and swelling. In sexually active men it is often caused by chlamydia or gonorrhea.
- An injury.
- A hernia in the groin, or a kidney stone with pain spreading down to the testicle.
- Fluid or enlarged veins in the scrotum (hydrocele, varicocele or spermatocele).
- Testicular cancer: almost always a painless lump. According to MedlinePlus, any lump in a testicle should be checked by a doctor.
How we help by video
You see Dr. Diana Nieves Castro, MD, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. That experience matters here: she knows which pain cannot wait.
A video visit is for mild pain that came on gradually, without swelling or fever. The doctor asks how it started, whether you have burning or discharge, and about recent partners. According to the CDC, every suspected case of epididymitis is tested for chlamydia and gonorrhea with a NAAT, and urine is the preferred sample in men: we give you a lab order for a lab near you. According to the CDC, most men with epididymitis can be treated without a hospital stay; if appropriate, the doctor prescribes and we send your prescription to your pharmacy.
If you have a painless lump, the doctor refers you for an ultrasound and an in-person evaluation. If she needs to see the area, it is done only through the secure visit link; do not send photos by email or text message.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer.
Get your plan.
A lab order, a prescription if appropriate or an in-person referral.
Price
A doctor visit costs US$79, with no membership, and includes the lab order. You pay the lab for the tests. Reviewing the result is a US$49 follow-up visit. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. See all prices.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
Epididymitis and your partner
If epididymitis comes from an STI, according to the CDC your sex partners from the 60 days before your symptoms should be evaluated and treated; if you had no partners in that time, your most recent partner. Each partner needs their own evaluation with a doctor. The doctor helps you plan how to tell them. More on STI testing and treatment.
For relief in the meantime, MedlinePlus suggests wearing an athletic supporter, applying ice and taking an over-the-counter pain reliever if you can take one.
If you are under 21
If you are under 21, a parent or legal guardian must sign the consent, stay on camera for the whole visit and show photo ID. Remember: in children and teens, testicular pain goes to the ER.
Frequently asked questions
When is testicular pain an emergency?
How long is there to save a twisted testicle?
Is epididymitis an STI?
Is a painless lump in the testicle serious?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-10-02 · Updated: 2026-10-02
Sources (3)
- Testicular torsion (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- Testicle pain (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-10-02)
- CDC: Epididymitis, STI Treatment Guidelines 2021 (opens in a new tab) (accessed 2026-10-02)