Testicles — the egg-shaped organs that sit just below the penis — are often the site of referred pain from surrounding areas. Referred pain can also radiate down the inner thigh.
Many nerves, blood vessels, and muscles run through the pelvic and groin region. Slight strains or unusual sensations may seem more magnified in this area.
Where you experience pain around the testicles can also tell you a lot about what might be causing the pain. For example, issues like testicular torsion or testicular cancer may cause pain in the testicles, but they’re also likely to cause pain in the groin and lower abdomen. They’re unlikely to cause pain in the thigh or upper leg.
In fact, most causes of pain in the testicle and thigh (or any part of the leg) usually arise from non-urological issues, like pinched nerves, herniated discs, or muscle strain. While these issues are not comfortable and do take some time to treat, they’re rarely an emergency or serious.
Always seek a medical evaluation for acute and chronic testicular pain, particularly if you aren’t sure of its origin. Once a diagnosis is made, an appropriate treatment plan can be put in place.
Keep reading to learn what might cause pain in your testicle and inner thigh and how these conditions are diagnosed.
There are several potential causes of testicular pain that extends to the thigh, some of which can develop suddenly with no obvious cause. Among the more common causes of testicle and thigh pain are:
Getting hit in the scrotum — the pouch of skin that surrounds the testicles — can trigger considerable pain in the testicles immediately. Testicular trauma may also cause pain to radiate up into the abdomen or down the leg.
Other symptoms may include:
- blood in the urine
- difficulty urinating
If the injury seems minor and the pain passes quickly, you may not need medical attention. But if pain persists for hours or there are noticeable symptoms, see a doctor as soon as you can. If any tissue within the scrotum has been badly injured, surgery may be needed to repair the damage. If not, rest and a cold pack may be all you need to do.
Pinched or compressed nerve
Problems in your spine may be responsible for pain in your testicle and leg. For example,
A herniated disk can also cause pinching of the nerve root, and the pain may not be localized to the disk or nerve itself. Instead, the pain may extend downward to the pelvis, groin, or inner thigh. Typically, the pain will be on the same side of the body as the pinched or compressed nerve.
The sciatic nerve extends from the lower spine, into the pelvis, and into the top of the legs. When this nerve is irritated, it can cause pain, numbness, and weakness in your back, groin, and eventually legs.
Muscle strains and tears are the consequence of overuse of muscles. This may be the result of an injury or trauma, or simply the result of using the muscle extensively without thoroughly warming it up.
A muscle strain in the pelvis or groin may cause pain in the testicle and upper thigh. It might also cause muscle spasms, muscle stiffness, and limited movement.
Symptoms of an inguinal hernia include:
- bulging in the groin area that may be painful to the touch
- pain when coughing, exercising, or bending over
- burning sensations
- a heavy or full sensation in the groin area
- swelling of the scrotum in men
Surgery is the most common treatment for inguinal hernias that can’t be pushed back into the abdomen.
Intestinal issues such as constipation, diverticulitis, colitis, peritonitis, and even appendicitis can all cause referred testicular and lower extremity pain. It’s important to see a doctor if you suspect you have one of these conditions.
- Constipation. This common digestive problem is defined as having hard, dry bowel movements or passing stool fewer than three times a week. Persistent abdominal pain and pain in the lower back are just some of the symptoms you may experience.
- Diverticulitis. This common disease occurs when pouches form along the digestive tract, usually in the colon. These pouches can become inflamed and infected. Symptoms include constant pain in your abdomen.
- Colitis. This inflammation of your colon (large intestine) causes discomfort and pain in your abdomen, which may be mild and reoccurring over time, or severe and appear suddenly.
- Peritonitis. This condition occurs when your peritoneum becomes inflamed. The peritoneum is the thin layer of tissue that covers the inside of your abdomen and some of the organs. The inflammation is typically caused by fungal or bacterial infection. It can cause tenderness and pain in your abdomen and lower extremities.
- Appendicitis. The appendix is a small pouch attached to your intestine. When your appendix becomes blocked, bacteria can build up inside it. This leads to inflammation and painful pressure in your abdomen, usually on your lower right side. An appendix can burst if left untreated, causing bacteria to enter into your abdominal cavity. This can be serious and sometimes fatal. See a doctor immediately if you suspect you have appendicitis.
Urinary stones develop when minerals like calcium and uric acid form into hard crystals. Small stones the size of a grain of sand may not cause any symptoms and may pass on their own. But larger stones can cause renal colic, especially if they cause an obstruction in the ureter or kidney.
Symptoms include intense pain along the side of your body between your ribs and hip, and in your lower abdomen. The pain may also radiate to the testicle and to the hip or leg as well.
See a doctor if you have symptoms of renal colic or urinary stones.
It’s not uncommon for the right testicle to be a little larger than the left testicle. This difference doesn’t indicate a problem unless there are symptoms, such as pain, swelling, redness, or difficulties urinating or ejaculating.
There’s little difference between the right and left testicles. If anything, the left testicle may be more vulnerable to conditions such as varioceles, an enlargement of the vein within the scrotum. But pain from sciatica, muscle strain, spinal problems, or injury can occur in either testicle.
If you see a doctor about testicle pain and inner thigh pain, you’ll be asked about other symptoms you might be experiencing. Your doctor will also get a medical history and perform a physical exam.
Possible tests you can expect include:
- blood tests to check for infection or other health problem
- urine test, which can also indicate the presence of an sexually transmitted infection (STI)
- an ultrasound of the testicles to look for injury or trauma to the muscles
If a herniated disc is suspected, your doctor may order a CT scan or an MRI. Either of these tests should show the bulging tissue. An X-ray won’t show a herniated disk, but it can rule out other potential causes.
Pain in the testicle and inner thigh can be triggered by any number of acute or chronic conditions. Some problems, such as a strained muscle or pinched nerve, typically run their course and resolve on their own. Other conditions, such as a herniated disc, may require more extensive treatment.
Sudden or severe testicle pain — or pain that is accompanied by symptoms like a fever or blood in urine — may be a medical emergency. You should see a doctor immediately.