It’s a weird, sickening feeling. You feel a dull throb or a sharp pinch in your gut, and then, almost instantly, it radiates down. Or maybe it’s the other way around. One minute you’re dealing with a nagging stomach and testicle ache, and the next, you’re doubled over wondering if your appendix is about to burst or if you just lifted something the wrong way at the gym. It’s unsettling. Because these two areas of the body are so biologically vital, the brain tends to go into high-alert mode when they both hurt at once.
Honestly, the connection isn't just in your head. It’s in your nerves. Specifically, the way your body was wired before you were even born.
When you were just a tiny embryo, your testicles didn't start where they are now. They actually developed near your kidneys, way up in the abdomen. As you grew, they "descended" through the inguinal canal into the scrotum. But they didn't just move down and cut ties; they dragged their nerve supply and blood vessels along with them. This is why a problem in your abdomen can feel like a kick to the groin, and a hit to the balls can make you feel like you're going to vomit. Doctors call this "referred pain." It’s basically a biological prank where the brain can’t quite figure out where the signal is coming from because the wiring is so tangled.
The Heavy Hitter: Inguinal Hernias
If you’re feeling a bulge in your groin area along with that persistent stomach and testicle ache, you might be looking at an inguinal hernia. This happens when a bit of fat or a loop of your intestine pushes through a weak spot in your abdominal muscles. It’s incredibly common. About 27% of men will deal with a hernia at some point in their lives.
Sometimes the pain is just a dull pressure. You might notice it more when you cough, bend over, or lift a heavy box of books. But if that tissue gets "strangulated"—meaning the blood supply is cut off—it becomes a surgical emergency. You’ll know the difference. The pain goes from "this is annoying" to "I need an ER right now" very quickly. According to the Hernia Center of Ohio, the sensation of "pulling" in the scrotum is one of the most cited symptoms by patients who eventually seek repair surgery.
Kidney Stones: The Silent Traveling Pain
You wouldn't think a tiny crystal in your urinary tract could cause your testicles to throb, but it does. Kidney stones are notorious for this. As a stone moves from the kidney down the ureter—the thin tube leading to the bladder—the pain migrates.
It starts as a stabbing sensation in the flank or the lower back. Then, as the stone scrapes its way down, the pain "follows" the nerve pathways. Many men arrive at the urologist complaining of testicular pain, only to find out via ultrasound that the culprit is actually a 5mm jagged stone stuck halfway between their kidney and bladder. Dr. Brian Stork, a board-certified urologist, often points out that because the T11 to L1 nerve roots serve both the ureters and the scrotal contents, the brain simply gets the messages crossed.
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Testicular Torsion is the Real Emergency
We need to talk about the one you can't ignore. Testicular torsion is when the spermatic cord twists, cutting off blood flow to the testicle. This isn't just an ache; it’s usually a sudden, agonizing event. However, in some cases, it can cause "intermittent" pain that feels like a cramp in the lower stomach.
If you have sudden, severe pain on one side of the scrotum accompanied by nausea and abdominal cramping, stop reading this and go to the hospital. You have about a six-hour window to save the testicle. There is no "waiting it out" with torsion.
Prostatitis and the Deep Ache
Sometimes the source is the prostate. Chronic prostatitis or Chronic Pelvic Pain Syndrome (CPPS) can create a "heavy" feeling in the pelvis. It’s less of a sharp jab and more of a foggy, constant stomach and testicle ache that makes it hard to sit comfortably for long periods.
It’s often linked to inflammation or infection, but sometimes it’s just pelvic floor dysfunction. Your muscles get "locked" in a state of tension. Think about how your shoulders get tight when you’re stressed. Your pelvic floor can do the same thing. This tension refers pain upward into the bladder area and downward into the scrotum.
Infections and Epididymitis
Then there’s the "itis" family. Epididymitis is inflammation of the coiled tube at the back of the testicle. It’s usually caused by an infection—sometimes an STI like chlamydia or gonorrhea, but sometimes just common E. coli.
As the inflammation spreads, it travels up the spermatic cord. This creates a secondary ache in the lower abdomen. You might notice some swelling, redness, or a fever. It’s usually treated with a round of antibiotics, but you have to get it swabbed first to know which bug you’re fighting.
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The Role of Nerves and "The Hidden Nerve"
Have you ever heard of the genitofemoral nerve? Most people haven't. It’s a nerve that starts in your psoas muscle (in your lower back/abdomen) and splits into two branches. One branch goes to your thigh, and the other goes straight to the scrotum and the cremaster muscle.
If you have a tight psoas from sitting at a desk all day or if you've had a minor back injury, that nerve can get compressed. The result? A weird, tingly, or aching sensation that hits both your lower gut and your groin simultaneously. It’s not an "organ" problem, but a "mechanical" one. Physical therapists see this all the time in cyclists and office workers.
Digestive Links: Can Gas Cause Testicle Pain?
It sounds ridiculous. But yes, severe bloating or a backup in the descending colon (the left side of your gut) can put pressure on the nerves in the pelvic cavity. While it’s rarely the primary cause of intense testicular pain, it can certainly contribute to a general sense of pelvic fullness and discomfort that feels like it’s "down there." Constipation is a frequent flyer in the world of referred pelvic pain.
How to Distinguish the Source
Trying to figure out where the pain starts is the first step in talking to a doctor. Ask yourself these specific questions.
- Does the pain change when I move? If shifting your weight or standing up makes it worse, it’s more likely a hernia or a muscle/nerve issue.
- Is there a fever? Fever usually points toward infection (prostatitis or epididymitis).
- Does it hurt to pee? If yes, think kidney stones or a UTI.
- Is one testicle higher or at a weird angle? That’s a major red flag for torsion.
Actionable Steps for Relief and Diagnosis
You don't just have to sit there and hurt. While you wait for a medical appointment, there are specific things you can do to narrow down what’s happening.
Perform a Self-Exam
Check for lumps. A hernia will often feel like a soft squish or a grape-sized bulge in the crease of your groin. A varicocele—which is basically a varicose vein in the scrotum—will feel like a "bag of worms." These aren't usually emergencies, but they do cause a dull stomach and testicle ache after a long day of standing.
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Monitor Your Hydration
If you suspect a kidney stone, start drinking water like it’s your job. But don’t go overboard; just stay consistently hydrated. If the pain is coming from a stone, you’ll likely notice the ache move further down toward your bladder as the day progresses.
The Support Test
If the ache is mostly in the testicle and radiates up, try wearing more supportive underwear. If switching from boxers to briefs or a jockstrap relieves the stomach ache, the issue is likely "traction" or strain on the spermatic cord. This is common in athletes or men who do a lot of heavy lifting.
Track the Nausea
Nausea is a huge clue. If the stomach ache feels like you’re about to throw up every time the testicle throb hits, that’s a sign of a high-intensity nerve response. This is common with torsion and kidney stones. If there’s no nausea, it’s more likely a chronic, low-level issue like prostatitis or a minor hernia.
Get an Ultrasound
If the pain persists for more than a few days, a scrotal and abdominal ultrasound is the gold standard. It’s non-invasive and can quickly rule out the scary stuff like tumors or torsion. Most doctors will also order a urinalysis to check for blood (kidney stones) or white blood cells (infection).
Don't ignore a persistent stomach and testicle ache. While it’s often something manageable like a strain or a minor infection, the "referred" nature of the pain means the actual problem could be hiding somewhere other than where you feel it most. Listen to the location, watch for swelling, and don't hesitate to seek a professional opinion if the pain is sharp or accompanied by a fever.