TESTICULAR AND SCROTAL PAIN
Testicular Pain: Pelvic Floor Physical Therapy in NYC.
An ache, pull or burning in one or both testicles that comes and goes. A normal ultrasound. Antibiotics that didn’t change anything. Pain that’s worse after sitting, exercise or ejaculation.
When testicular pain lasts for months and testing finds no cause, the source can be outside the testicle itself. In some men, tension and tenderness in the pelvic floor and nearby muscles refer pain into the scrotum, and that is something physical therapy can assess and treat.
UNDERSTANDING YOUR SYMPTOMS
When the pain
isn’t in the testicle.
Chronic scrotal pain, also called orchialgia, is pain in the testicles, epididymis or spermatic cord that lasts three months or longer. Infection, injury, a hernia, a varicocele and problems in the spine or abdomen can all cause it, and many men have no clear cause on testing.
The nerves that supply the scrotum also supply the pelvic floor, the inner thigh and the lower abdomen. When those muscles are guarded or tender, the brain can register the pain in the testicle even though the testicle itself is healthy.
Scrotal pain is also a common part of chronic pelvic pain syndrome, and it sometimes begins after a vasectomy or hernia repair.
Common symptoms
- A dull ache, pulling or heaviness in one or both testicles
- Burning or sharp pain that comes and goes
- Pain that spreads to the groin, inner thigh or lower abdomen
- Perineal pain or pressure between the scrotum and anus
- Pain that is worse after sitting, cycling or lifting
- Pain during or after ejaculation
- Sensitivity to tight underwear or pressure
- Urinary symptoms, such as frequency or urgency
Symptoms vary from person to person and often change over time.
WHY THE PELVIC FLOOR MATTERS
What we assess,
and how we treat it.
Every session is one-on-one with Dr. Joshua Weber, PT, DPT, in a private treatment room. Nothing is done without explanation and your agreement, and you set the pace.
We check the pelvic floor, the hip and inner thigh muscles, the abdominal wall and the nerves that pass through them, looking for tenderness that reproduces your familiar pain.
Finding the spot that recreates your testicular pain is often the most useful part of the visit. It shows where the pain is actually coming from and gives treatment a clear target.
How treatment works at Pelvic Lab
- 01
Hands-on manual therapy
For the pelvic floor, inner thigh and abdominal muscles, including internal treatment only when appropriate and with your consent.
- 02
Relaxation and breathing
Training to reduce pelvic floor guarding and help the muscles let go at rest.
- 03
Nerve mobility
Gentle techniques for the nerves of the groin and pelvis, especially after hernia repair or vasectomy.
- 04
Sitting and activity changes
Adjusting sitting, cycling, lifting and training so they stop flaring your symptoms.
- 05
Coordinated care
Working with your urologist when nerve blocks, medication or other treatment is part of your plan.
- 06
A home program
Exercises and habits to use between visits, adjusted as you progress.
We can’t promise a result. In one study of 30 men whose chronic scrotal pain came with pelvic floor tenderness, half reported improved pain after physical therapy, and fewer needed pain medication afterward (Farrell et al., 2016). That’s why the pelvic floor exam matters.
YOUR FIRST VISIT
A 45-minute
evaluation.
We’ll review your symptoms, medical history, imaging and previous treatments, and talk through your goals. The physical assessment may include breathing, movement, the hips, abdomen and pelvic floor, and every part is explained first.
You’ll leave with a clear explanation of what we found, whether physical therapy is the right fit for you, and a recommended plan of care.
WHEN TO SEE A PHYSICIAN FIRST
Medical care
comes first.
Testicular pain needs a medical evaluation before physical therapy, usually an exam and a scrotal ultrasound. If you haven’t seen a urologist, start there.
Physical therapy works alongside medical care, not in place of it.
Seek prompt medical care for:
- Sudden, severe testicular pain, with or without nausea or vomiting (emergency)
- Rapid swelling, redness or warmth of the scrotum, or fever
- Pain after an injury to the testicles
- A new lump or hard area in a testicle
- New numbness in the groin or saddle area with changes in bladder or bowel control (emergency)
FREQUENTLY ASKED QUESTIONS
A few things
you may be wondering.
My ultrasound was normal. Why do I still have pain?
An ultrasound shows the structures inside the scrotum, not the muscles and nerves around them. Pain referred from the pelvic floor, inner thigh or groin nerves won’t appear on imaging, even when it feels like it’s coming from the testicle.
Can physical therapy help pain after a vasectomy?
It can when muscle guarding or nerve sensitivity is contributing. Your urologist should evaluate post-vasectomy pain first, since some causes need medical or surgical treatment.
Is it the same as chronic prostatitis?
They often overlap. Testicular pain is one of the most common symptoms of chronic prostatitis, also called chronic pelvic pain syndrome. See Chronic Pelvic Pain.
Should I stop exercising?
Usually not. We’ll look at which activities flare your symptoms and adjust them, rather than asking you to stop everything indefinitely.
Is an internal exam required?
No. An internal pelvic floor assessment can be useful, but it is always optional. We’ll explain why it may or may not help, and you decide. You can pause or stop any part of care at any time.
Do I need a referral?
No. In New York, qualified physical therapists can treat without a referral for up to 10 visits or 30 days, whichever comes first.
Do you take insurance?
Pelvic Lab is a direct-pay practice. We provide a superbill you can submit to your insurance company for possible out-of-network reimbursement. Coverage depends on your plan.
YOUR NEXT CHAPTER STARTS WITH A CONVERSATION
Specialized pelvic floor care
for men in Manhattan.
16 Madison Square West, Suite 1047, in the Flatiron District.
Book your evaluation, or speak with Dr. Weber first.