my friend is complaining about lower abdomen pain and in the back and can barely walk

Dear Anonymous,

Testicular pain can be caused for many reasons: 

Trauma

Testicular Torsion: a surgical emergency. It occurs when the testicle twists inside the scrotum, either spontaneously or less commonly, as a result of direct trauma. When the testicle twists, the blood vessels contained within the spermatic cord also twist leading to an interruption of blood flow to the affected testicle. 

Epididymitis: Epididymitis (inflammation of the epididymis) is most often due to an infection. It is the most common cause of testicular pain in men older than 18 years of age, though it can also occur in prepubertal individuals and the elderly.

Torsion of a testicular appendage: This is a common cause of testicular pain in younger boys, with most cases occurring between the ages of 7 and 14 years. 

• The testicular appendage and the epididymal appendage are basically functionless tissue remaining from human embryonic development. As in testicular torsion, the twisting of these structures can lead to an interruption of blood flow, leading to varying amounts of testicular pain.

Less common reasons include: 

• Inguinal hernia:This condition occurs when part of the intestine protrudes through a muscular defect in the groin area and slides into the scrotum. This may cause scrotal swelling and testicular discomfort.
  
  
• Orchitis (inflammation of the testicle):This inflammatory condition of the testicle generally occurs because of an infectious process. It is sometimes found along with epididymitis  (epididymo-orchitis), especially when epididymitis has gone untreated for several days. Most cases of orchitis are caused by aviral mumps infection, though other viruses and bacterial organisms can also cause it.
  
  
• Testicular tumor: A tumor rarely causes  testicular pain. It is important to conduct regularself-examinations of the testiclesto locate any lumps or masses, as early detection improves the prognosis for testicular cancer.
  
  
• Kidney stone:The pain fromkidney stonesmay sometimes radiate into the testicular area.
  
  
• Infections or bleeding in the abdomen: This rarely causes testicular pain.

Please have your friend go to the Emergency Department if the pain is getting worse and/or he is finding it harder to walk.

Best,

Rosa