Men's Pelvic Condition
Chronic Epididymitis
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
The coiled tube behind your testicle is sore, tender or aching, and it has been that way for weeks or months. Maybe it began with an infection that was treated. Maybe no infection was ever found. When epididymal pain outlasts any active infection, irritated nerves and a guarded pelvic floor are often what keep it going.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Chronic Epididymitis
The epididymis is a tightly coiled tube at the back of each testicle that stores and carries sperm. Epididymitis is inflammation of this structure. Acute epididymitis, usually caused by infection, comes on quickly with swelling and pain and needs prompt medical treatment with antibiotics.
Chronic epididymitis means pain or discomfort in the epididymis lasting six weeks or longer. For many men, the infection has been treated or was never found, yet the pain continues. Nerves along the spermatic cord can stay irritated, and the pelvic floor, cremaster and groin muscles tighten in response to ongoing pain. Those muscles then refer pain back to the scrotum, which keeps the area sensitive long after the original trigger has passed.
Your urologist rules out active infection, torsion, hernia and testicular problems and manages any medical treatment. Dr. Gordon's focus is the nerve and muscle side that often explains why the pain lingers.
Chronic Epididymitis at a Glance
Also called
Chronic epididymal pain, chronic scrotal content pain
How long
Pain lasting six weeks or longer
Where it is felt
Behind the testicle, scrotum, groin, sometimes the lower abdomen or perineum
Common aggravators
Sitting, exercise, sex and ejaculation, tight clothing, prolonged standing
Main drivers
Lingering nerve irritation, pelvic floor and cremaster guarding, groin nerve sensitivity
The Gap in Care
What Tests Check, and What They Can Miss
Ruling out active infection and testicular problems is essential. After that, repeated antibiotic courses rarely help pain that is being maintained by nerves and muscles.
What routine testing is looking for
- Active bacterial infection
- Testicular torsion or masses
- Hernia or fluid collections
- Findings on scrotal ultrasound
What often keeps symptoms going
- Irritated nerves along the spermatic cord
- A cremaster muscle that stays tight
- Pelvic floor tension that refers pain to the scrotum
- Groin and inner thigh trigger points
- A sensitized nervous system after weeks of pain
These are assessed by examining the groin, hips and pelvic floor.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
Aching behind the testicle
A dull or throbbing pain at the back of one testicle that can come and go or stay constant.
Tenderness to touch
Soreness when the area is pressed, when sitting, or with tight underwear.
Pain spreading to the groin
Discomfort traveling up the spermatic cord into the groin or lower abdomen.
Pain with ejaculation
Discomfort during or after orgasm that can linger for hours.
Flares with activity
Symptoms that increase after exercise, lifting or long periods standing.
Perineal or pelvic tension
A feeling of tightness or pressure behind the scrotum or in the pelvis.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Lingering nerve irritation
Nerves in the spermatic cord can stay sensitive after inflammation settles, continuing to send pain signals from the epididymis.
Cremaster and pelvic floor guarding
The cremaster muscle lifts the testicle and the pelvic floor supports the area. Both tighten with pain and can hold that tension long term.
Groin and inner thigh trigger points
Trigger points in the adductors and lower abdominal wall commonly refer pain into the scrotum and testicle.
Groin nerve sensitivity
The ilioinguinal and genitofemoral nerves supply the scrotum and can become irritated along with the epididymis.
Your First Visit
How Dr. Gordon Evaluates Chronic Epididymitis
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your urology notes, ultrasound results, cultures and antibiotic history to confirm that active infection has been ruled out.
Groin and nerve mapping
Assessment of the groin, lower abdomen, inner thighs and hips along the paths of the nerves that supply the scrotum.
External pelvic floor assessment
The pelvic floor muscles are examined from the outside, with no internal exam. With you draped for comfort, gentle pressure around the perineum, sit bones, tailbone and inner thighs checks tone, tenderness and trigger points.
Activity and flare review
Dr. Gordon looks at how sitting, exercise, sex and work affect your symptoms.
Plan and coordination
A clear plan, plus communication with your urologist or pelvic floor PT when that helps your care.
When to see a physician first
- Sudden, severe testicular pain, which can be torsion and is an emergency
- Fever, chills or rapidly increasing swelling
- A new lump in the testicle
- Visible blood in the urine or semen
- Burning urination with discharge
- Inability to urinate
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for chronic epididymitis, chosen from your exam findings.
Primary approach
Intrapelvic & Extrapelvic Dry Needling
Dr. Gordon holds ASE certification in both intrapelvic and extrapelvic dry needling. Treatment targets the pelvic floor, groin and inner thigh muscles that guard around the scrotum and refer pain into the testicle. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum.
Learn about pelvic floor treatmentNerve focus
Neuro-Functional Acupuncture
Gentle electro-acupuncture along the groin and sacral nerve pathways to calm lingering nerve irritation.
See servicesBetween visits
Support Plan & Team Coordination
Guidance on support, activity, sitting and flare control, plus coordination with your urologist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"Dr. Gordon is thoughtful, thorough and incredibly knowledgeable. He has significantly helped me with pain management and pelvic floor issues. I am grateful to have his expertise in my corner."
Dina Isola, Google Review
Chronic Epididymitis Questions
Answers About Chronic Epididymitis
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
If there is an active infection, yes, and that is managed by your physician. When cultures are negative or pain continues after treatment, more antibiotics usually do not help, and it is worth looking at nerve and muscle contributors.
Your urologist should examine you and usually order an ultrasound. Sudden severe pain, a new lump, fever or rapid swelling need prompt medical care.
Muscles in the groin, inner thigh and pelvic floor share nerve supply with the scrotum. When they hold tension, they refer pain to the testicle, which can feel identical to pain from the epididymis itself.
Treatment focuses mainly on the groin, hips, inner thighs and pelvic floor. Everything is explained before anything begins, and nothing is done without your consent.
Many men need eight to twelve sessions with reassessment along the way. Dr. Gordon gives you an estimate at your first visit.
Usually yes, with adjustments to load and support while symptoms settle.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For chronic epididymitis, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
It is a technique that reaches the deep pelvic floor muscles, including the levator ani, obturator internus and coccygeus, to release trigger points and restore normal muscle function. The needles go in through the skin of the buttock, perineum or inner thigh, never through the vagina or rectum. Dr. Gordon holds ASE certification in this technique, which few practitioners in New York have.
Yes. Your privacy and comfort come first. When undressing is needed for the area being treated, you are fully draped. Needles are placed through the skin only, and nothing is ever inserted into the vagina or rectum. You can pause or stop at any time.
Yes. Many men put off care for pelvic and genital symptoms because the topic feels awkward. Dr. Gordon keeps things straightforward and clinical, explains every step, and treats adults of all genders and identities in a respectful, welcoming setting.
It helps to have had a medical workup so serious causes have been checked. If you have not seen a urologist for these symptoms yet, call the clinic to talk through the best order of steps.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Chronic Epididymitis
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Early morning, evening and weekend appointments available. Free on-site parking.
Symptoms
Common Symptoms of Chronic Epididymitis
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