• Neff S
• Holguin S

• Adult
• Chronic Pain
• Low Back Pain
• Male
• Open Access Document
• Testis

Objective: To describe the care of a veteran with low back pain and chronic phantom orchialgia treated with spinal manipulation and manual therapy.

Clinical Features: A 29-year-old Caucasian male veteran with a 7-year history of low back pain developed left testicular pain following a vasectomy. He was diagnosed with testicular cancer undergoing a left orchiectomy and removal of 36 lymph nodes from the left pelvis and lumbar spine. The left testicular pain continued.

Intervention and Outcome: Treatment included spinal manipulation and myofascial release of the iliopsoas bilaterally as well as training in iliopsoas stretches and self-myofascial release. The pain steadily decreased over the initial trial to 1/10. The QVAS improved by 53% and the BBQ by 54%.

Conclusion: Chronic orchialgia or chronic scrotal pain affects 100000 men per year in the US. As many as 50% of the cases have an unknown etiology. Though the urology literature does not include spinal manipulation and manual therapy in standard conservative care for chronic orchialgia, a growing number of publications have shown it to be safe and effective. This case demonstrates successful treatment of chronic phantom orchialgia. A trial of chiropractic care in cases of chronic orchialgia would potentially reduce orchiectomy in idiopathic cases and could provide relief in post orchiectomy cases. 

Author keywords: Chiropractic; Manual Therapy; Low Back Pain; Orchialgia; Urology; Phantom Pain; Manipulation

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