I have a very small lump on the left side of my scrotum and its painfull at times what could it be?

Cyst: If it is painful it is best to echecked by urologist to examine scrotum swell as testicles to makewure you do not have anything serious such as a growth.

It could be...: Depending on your age and the location, size, etc of the lump this could be a great many things ranging from benign (like torsion of the testicular appendix) to serious (like testicular cancer). Any new lump, especially a painful one, in the scrotum must be taken seriously. However, it needs to be seen to be properly evaluated. Don't delay seeing you doctor. Go right away!

Epididymal cyst: A small tender lump above the testis is most likely an epididymal cyst, which is quite benign. However could be removed it bothers u too much. Not a tumor, these are painless unless it has a hemorrhage. Not torsion of the testis or appendix testis, the latter if tender is only painful at the time it twists and then necroses. Have it checked out.