Why Does My Right Nut Hurt? When to Panic and When it’s Just Weird

It happens. You’re sitting there, maybe scrolling through your phone or just getting up from the couch, and suddenly there’s a sharp, nagging, or dull throb. You ask yourself: why does my right nut hurt? It’s an uncomfortable question. It’s even more uncomfortable to talk about. Most guys immediately jump to the worst-case scenario—cancer or some catastrophic failure of their plumbing. While your mind is racing toward the "worst thing possible," the reality is usually a bit more nuanced, ranging from a simple muscle strain to something that actually requires a trip to the ER.

Don't ignore it. That’s the first rule. The anatomy of the scrotum is incredibly sensitive for a reason; it’s a high-priority warning system for your body. Whether it’s a dull ache that’s been lingering for three days or a sudden, lightning-bolt pain that makes you double over, your body is trying to tell you something.

The Sudden Emergency: Testicular Torsion

If the pain in your right testicle came on like a freight train—sudden, agonizing, and maybe accompanied by nausea—stop reading this and go to the hospital. Seriously. This is likely testicular torsion.

What’s actually happening? Basically, the spermatic cord, which provides blood flow to the testicle, gets twisted. It’s like a garden hose kinking, but instead of water, it’s your blood supply. When that flow is cut off, the tissue starts to die. This isn't something you can "walk off." Doctors usually have a six-hour window to untwist it before permanent damage or loss of the testicle occurs.

Interestingly, torsion often happens because of something called the "bell clapper deformity." Most guys have their testicles firmly attached to the scrotum. Some are born with a genetic quirk where the testicle can rotate freely like the clapper inside a bell. If you have this, you’re just more prone to a random twist. It often happens during sleep or after intense physical activity. It’s terrifying, but surgeons fix it relatively easily if they catch it in time.

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The Slow Burn: Epididymitis and Infection

Maybe your pain isn't a 10/10. Maybe it’s a 4/10 that’s just... there. It feels heavy. It feels tender when you touch the coiled tube at the back of the testicle. This is often epididymitis.

The epididymis is where your sperm matures. It’s a very long, very thin tube that can get inflamed or infected. In younger men, this is frequently caused by a sexually transmitted infection (STI) like chlamydia or gonorrhea. In older men, it’s more likely a urinary tract infection or an enlarged prostate causing backflow.

• Symptoms: Swelling of the scrotum, redness, and sometimes a fever.
• The "Prehn’s Sign": Doctors sometimes check if lifting the scrotum relieves the pain. If it does, it points toward epididymitis rather than torsion.
• Treatment: Usually a round of antibiotics. If it’s an STI, your partner needs treatment too, or you’ll just keep passing it back and forth like a bad birthday gift.

Varicoceles: The "Bag of Worms"

Have you ever felt your scrotum and thought it felt like a bag of spaghetti or worms? That’s a varicocele. It’s essentially a varicose vein, but in your nutsack.

These are incredibly common. About 15% of men have them. They usually happen on the left side due to the way the veins are routed, but they can absolutely happen on the right. When they occur on the right, it’s sometimes worth a closer look by a urologist to ensure there isn't something (like a kidney mass) pressing on the vein further up in the abdomen.

Varicoceles cause a dull, dragging ache. The pain usually gets worse throughout the day as gravity does its thing, pulling more blood into those dilated veins. Laying down usually makes the pain go away because the blood can finally drain out. It’s rarely dangerous, but it can affect sperm count and quality because the extra blood pooling there raises the temperature of the testicles. Cold showers and supportive underwear are the low-tech fixes, while minor surgery is the high-tech one.

Referred Pain: It's Not Actually Your Nut

Sometimes, the reason your right nut hurts has nothing to do with your testicles at all. The nerves in your groin are like a confusing electrical grid.

Kidney stones are a classic culprit. A stone scraping its way down your ureter can trigger intense pain that radiates directly into the scrotum. You might feel like your testicle is being crushed, but the actual problem is a jagged little rock near your hip.

Inguinal hernias are another big one. This happens when a piece of your intestine or fatty tissue pushes through a weak spot in your abdominal wall. It can slide down into the scrotum, causing a bulge and a nagging ache. If you cough or lift something heavy and the pain spikes, a hernia is a prime suspect.

Testicular Cancer: The Fear vs. The Reality

Let's talk about the big C. Testicular cancer is the most common cancer in young men (ages 15 to 35), but here is the thing: it usually doesn’t hurt. Most guys who find a tumor describe it as a painless, rock-hard lump. If your right nut hurts, it’s actually less likely to be cancer than if you found a lump that felt like nothing at all. However, some tumors grow quickly and cause a dull ache or a heavy feeling.

Don't play doctor. If you feel a lump—any lump—get an ultrasound. Testicular cancer is one of the most treatable forms of cancer if caught early. Lance Armstrong is the famous example here; even with late-stage spread, survival rates are remarkably high compared to other cancers.

Why Does it Keep Happening? (Chronic Orchialgia)

Some guys deal with "ghost pain." Doctors call this chronic orchialgia. You go to the urologist, they do the ultrasound, they check for STIs, they check for hernias, and everything comes back "normal." Yet, the pain persists.

This can be incredibly frustrating. Sometimes it’s related to pelvic floor dysfunction—essentially, the muscles in your pelvis are too tight and are pulling on the nerves. Other times, it’s "blue balls" (epididymal hypertension), which is a real thing caused by prolonged arousal without release, leading to fluid congestion.

Then there’s the impact of your lifestyle. Are you wearing jeans that are way too tight? Are you sitting in a bucket seat in your car for four hours a day? Are you lifting heavy at the gym with bad form? Small, repetitive traumas can lead to lingering nerve irritation that feels like testicular pain.

Actionable Steps for Relief and Safety

If you're currently staring at the wall wondering what to do next, follow this protocol. It’s not medical advice—I'm a writer, not your doctor—but it's the standard path of care.

1. Perform a self-exam. Stand in a warm shower so the skin relaxes. Roll the right testicle between your thumb and fingers. You’re looking for lumps, changes in size, or areas that are significantly harder than the rest. Note: the epididymis at the back should feel like a soft bunch of tubes; don't mistake that for a tumor.
2. Check for "Red Flags." If you have a fever, blood in your urine, nausea, or a sudden change in the position of the testicle (e.g., it’s sitting higher or at a weird angle), get to an Urgent Care or ER immediately.
3. Supportive measures. Switch from boxers to supportive briefs or a jockstrap for 48 hours. If the pain is inflammatory, the extra support will reduce the "tug" on the spermatic cord.
4. The NSAID Test. Take an over-the-counter anti-inflammatory like ibuprofen. If the pain vanishes, it’s likely a minor strain or inflammation (like mild epididymitis or muscle pull). If the pain ignores the ibuprofen, it’s more likely structural or nerve-related.
5. Book the Ultrasound. This is the gold standard. A scrotal ultrasound is non-invasive, doesn't hurt, and can see everything from tumors and cysts to varicoceles and torsions. It provides the peace of mind that no amount of Googling can offer.

The "wait and see" approach is fine for a stubbed toe, but for testicular pain, the stakes are a bit higher. Most causes are benign and easily treated with a week of meds or better underwear, but the ones that aren't benign require speed. Listen to the alarm bells. If your right nut is hurting, give it the attention it's asking for.