Expert: Dr. Brendon J. O`Brien, D.C. - 2/20/2006

Question
Male, 52 years old.   Chronic low right-sided back pain, radiating into right groin. Sometimes into right knee.  Periodically have had dull aching right testicular pain, which usually resolves after a week or so.  Currently entering 9th week of continual testicular pain.  Internal Medicine MDs (2 of them) find no evidence of anything wrong.  Urology MD agrees: No testicular mass, urinary tract infection, etc.  PSA levels normal. Kidney functions normal.  No response to pain killers, or anti-inflammatories. No response to acupuncture.  MRI of 5 years ago showed: “…congenitally narrow spinal canal, some facet hypertrophy throughout the lumbar spine…..some end plate irregularities at T12-L1 and L1-L2.   No significant disc disease demonstrated……”  Appendectomy at age 18 -- still have slight pain at operative site.  General feeling of “tightness” in groin, low back, right flank. Inactive lifestyle, definitely not “in shape”.  Can deal with back pain. Testicular pain way too comfortable, as you can imagine. Any advice? Thank You.  

Answer
Helllo Mark,

   You may want to have a MRI again, especially if it has been 5 years since the previous MRI.  Nerve impingement in the lumbar spine or sacral nerves can cause radicular testicular pain.  Also hernias can cause this pain.  Hernias may worsen or reduce on their own, best to be seen when you are in severe pain to rule out a hernia.  You may also want to try chiropractic care.  Adjusting the spine and deep fascial work will reduce tension around the joint and may help relieve pressure off the irritated nerve.  Also doctors of chiropractic are the biomechanic experts of the spine, after the examination they should be able to tell if the symptoms are coming from impingement in the low back or spine.

Have a great day,
Dr. Brendon O'Brien D.C.