Low back and testicular pain

[ED50]

I have seen two patients this week referred to me with unilateral low back and testicular pain. To me these are separate and unrelated, but I wanted to hear from you all. Have you seen any correlate between the two?

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[GlowInTheDark]

MRI?

How does L1-L2 look?

 

[10KHertz]

I have two HNP with a annular tears at L4-5, L5-S1 with testicular pain. See it often . US neg for torsion or masses . If you truly think it’s testicular , have URO do a spermatic block .

 

[deleted875186]

I’ve seen a few patients with no urological cause, I even sent to gen surg to rule out a hernia, have lumbar disc herniation and they tell me the symptoms improve with LESI. I didn’t believe it was related, but I’ve now repeated the epidural several time and it seems to help quite significantly.

 

[RoloTomassi]

I see it with L5-S1 herniations sometimes

 

[soccrwz]

what do you think the reason for that is?

 

[RoloTomassi]

what do you think the reason for that is?

I think it's possible L5-S1 herniation can cause some S2 chemical irritation, or even mechanical if large. Or, since dermatomes are variable, maybe someone's S1 is more like S2

 

[SSdoc33]

Its disc

 

[Timeoutofmind]

I have seen two patients this week referred to me with unilateral low back and testicular pain. To me these are separate and unrelated, but I wanted to hear from you all. Have you seen any correlate between the two?

Examine hip…
Carefully….
Stinchfield etc

Presentation can be subtle

If exam concordant and X-ray beg, get MRI

Horses before zebras

 

[MitchLevi]

Discogenic pain commonly refers to the ol scrote. L4-5 and L5-S1 (as stated previously).

Listhesis or annular fissures.

 

[avalon10]

Do an S2 ESI, assuming they’ve been worked up for other causes of testicular pain (torsion, infection etc)