Possible causes of lower back and testicular pain include lumbar spondylolisthesis, epididymitis, kidney stones, and more. A doctor can diagnose the cause of the pain and advise on suitable treatments.

In this article, we discuss some possible causes of lower back and testicle pain. We also cover when to consult a doctor.

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Lumbar spondylolisthesis is a condition in which one of the vertebrae, which is one of the small bones comprising the backbone, in the lower part of the spine, or lumbar region, slips out of place. Spondylolisthesis can occur due to injuries, repetitive strain on the spine, or general wear and tear as someone gets older.

Lumbar spondylolisthesis can cause lower back pain if the slipped vertebra places pressure on one of the spinal nerves. This pain can sometimes radiate down to the testicles or legs.

Other symptoms can include:

These symptoms may improve when a person is sitting or leaning forward.

Treatment

Treatment options for lumbar spondylolisthesis include physical therapy to strengthen the lower back muscles and nonsteroidal anti-inflammatory drugs (NSAIDs) and pain medications to help reduce pain and swelling. For people with more severe symptoms, a doctor may prescribe steroid injections.

Surgical treatment may be necessary for people with lumbar spondylolisthesis that does not improve with other treatments and for those with a loss of nerve function.

Urinary tract infections (UTIs) can occur when bacteria build up in the urinary tract, which includes the bladder, kidneys, ureters, and urethra.

UTIs can cause pain or a burning sensation while urinating, and this pain may extend to the testicles. A person may also experience a constant urge to urinate.

Severe pain in the lower back or abdomen, along with fever, chills, nausea, and vomiting, can indicate a kidney infection, which is a more serious type of UTI.

Treatment

People with symptoms of a UTI, particularly a kidney infection, need to speak with a doctor as soon as possible.

Doctors typically prescribe antibiotics for individuals with a bacterial UTI. It is important to follow the doctor’s instructions when taking antibiotics and to complete the entire course.

Drinking plenty of water and urinating frequently can help speed up recovery. Over-the-counter (OTC) medications can also help relieve pain and discomfort.

Epididymitis is the swelling of the epididymis, a duct that stores and transports sperm from the testicles to the vas deferens. Doctors define the vas deferens as a coiled tube that carries the sperm out of the testicles.

The swelling of the epididymis can cause pain in the scrotum and testicles that sometimes radiates to other areas of the body, including the groin area and the lower back or sides.

Possible causes of epididymitis include sexually transmitted infections, such as chlamydia, and UTIs. However, there is not always an obvious cause, and in some people, epididymitis can be a chronic condition.

Depending on the cause, a person with epididymitis may also experience symptoms that include painful urination, fever, and a frequent urge to urinate.

Treatment

The type of treatment for epididymitis depends on the cause. A doctor will usually prescribe antibiotics for people with a bacterial infection.

Resting and elevating the scrotum can help reduce swelling. OTC anti-inflammatory medications, such as ibuprofen and naproxen, may also relieve pain and discomfort.

Kidney stones are hard mineral deposits that can form in the kidneys. Small kidney stones do not always cause symptoms, but larger stones can block the flow of urine from the kidneys.

Blockages can result in sharp pain in the lower back and sides that may also radiate to the lower abdomen, the groin area, and the tip of the penis.

Other symptoms of kidney stones can include:

  • blood in the urine
  • pain or difficulty urinating
  • an intense urge to urinate
  • nausea and vomiting

Treatment

The treatment options will depend on the severity of the symptoms and the size of the stones.

Smaller stones do not always require treatment and may leave the body in the urine. Drinking plenty of fluid can help the stones pass out more quickly. Doctors may also prescribe pain relievers and medications, such as tamsulosin, to relax the ureter.

A doctor may recommend a medical procedure to remove kidney stones that are large, very painful, or affecting kidney function. Removal procedures can include surgery or involve shock wave therapy to break the stone into smaller pieces that a person can pass.

Rarely, lower back and testicle pain can be a sign of testicular cancer.

The most common first symptom is either a lump on the testicle or the testicle becoming swollen or larger. Testicular cancer can sometimes cause pain in the testicle and a feeling of heaviness in the scrotum or lower abdomen. Some people may also notice breast soreness or unusual breast growth due to hormonal changes.

If testicular cancer spreads to other parts of the body, it can cause additional symptoms, such as:

Treatment

Treatment varies depending on the type and stage of testicular cancer when the doctor makes the diagnosis. Treatment options can include:

Pelvic floor dysfunction involves difficulty controlling the pelvic floor muscles. It forces the surrounding muscles to contract rather than relax.

A person with pelvic floor dysfunction may have difficulty controlling their urination and experience pain in the testicles. According to an older study from 2010, this pain is particularly likely to occur in younger people.

The condition currently affects around 100,000 men in the United States annually.

Other symptoms can include:

Treatment

Treatment options include pelvic floor exercises, with an emphasis on contraction, and biofeedback, which involves learning to control bodily processes that are usually involuntary.

Doctors may also prescribe medications, such as NSAIDs, to reduce inflammation.

If a person has severe symptoms or complications, a doctor may recommend surgery.

People with lower back and testicle pain need to speak with a doctor if the pain is severe, does not get better, or is interfering with daily life. It is also important to seek medical advice if the pain occurs along with other symptoms, such as an unexplained lump or swelling in the testicles.

A person needs to seek immediate medical attention for symptoms of kidney stones or a kidney infection. These can include:

  • fever and chills
  • blood in the urine
  • nausea and vomiting
  • severe pain in the sides, back, lower abdomen, or groin area
  • pain or difficulty urinating

When testicle pain occurs along with lower back pain, it can indicate an underlying condition. Possible causes include kidney stones, infections, and spinal problems.

People need to speak with a doctor if the pain is severe, does not go away, or occurs along with other concerning symptoms.