<Name> you have a typical case of varicocele. I group you into the category of sedentary living condition with postural and joint problems. 3 things will be critical for you:

1. Stretch and exercise daily to counter the negative effects of sitting. And, ensure to stay active. 
2. Cooling and support throughout the day are critical. You must also perform cooling treatments.
3. Dietary improvements are going to be critical for you.

Here are my recommendations for you: 

• grade 1 bilateral: Having pain symptoms and early stage varicocele is an indication that your lifestyle is playing an important role in your disease. It is also easier to treat early stage varicocele.
• some testicular atrophy: Some testicular atrophy is not good. It means that varicocele toxic blood pooling has already damaged your testicles to some degree. It is however a good sign that you do had a normal sperm count. However, the pain and atrophy do indicate that the condition could be progressing for worse.
• 5/10 pain: Pain means that your testicles and testicular veins are being damaged by varicocele. I believe that it needs to be treated right away. I treat it like a serious condition, because if left untreated, it can develop into infertility, impaired testosterone, and worsening of varicocele. https://www.varicocelehealing.com/varicocele-pain-treatment.html
• lower back pain: Typically, when I see a grade 1 varicocele, with pain symptoms, and a little overweight, I immediately think lifestyle. And, here is it... You have lower back pain from excessive sitting and inactivity.
• lower abdominal pain: Is this your varicocele pain? Or a separate pain?
• office work, sits for 7-8 hours per day: Sitting is a major risk factor for varicocele, and for you. Make sure to improve how you sit.  http://varicocelehealing.com/sitting
• joint pain (hip/knee and lower back): You should see a good personal trainer or physiotherapist to help you overcome your joint paints. Even 2-5 sessions can help you learn exactly what you need to focus on.
• going commando: Good this is better than wearing boxers or briefs. However, you do need some compression to and cooling if you want to decrease your pain symptoms:  https://www.varicocelehealing.com/store/p84/stud-underwear.html    
• started better diet after noticed bilateral varicocele: Good. It is important to manage blood sugar levels (low GI, and lowered glycemic load), promote and improve bowel health, high antioxidants, cruciferous vegetables, dark leafy greens, ensuring to wash your fruits and vegetables to remove any pesticides, organic over non-organic, run better food professing methods, ensure cooking and storage tools are non-toxic, remove unhealthy foods, etc.  https://www.varicocelehealing.com/varicocele-natural-treatment-without-surgery/category/varicocele-diet
• walking everyday, 45 minutes--but no exercise: You need to strengthen your posture and muscles that weakened by excessive sitting. You need to stretch the tight muscles, and begin better muscle balance.  http://varicocelehealing.com/exercising-with-varicocele
• trying to conceive 2nd baby: It's good that you were successful before. It's a good sign.
• normal sperm count: Good! That's really good. Let's keep it that way!
• "How to live without Varicocele pain.?" Follow the treatment programs I've outlined for you. 
• "How to cure varicocele permanently?" You need to take some serious steps toward lifestyle change, follow precautions, start with the Health Kit, and Stud Briefs. That's enough for your case.

There you are, those are some great free resources for you. No excuse to not start now.

Also, here is the treatment program that I recommend for you: The 80 Day Varicocele Complete Treatment Program: https://www.varicocelehealing.com/store/p142/complete-treatment-package.html, and at a minimum, try 2 pairs of Stud Briefs: https://www.varicocelehealing.com/store/p84/stud-underwear.html

Okay! That will help G. Please let me know if you require more support, I'm here to help. Again, don't wait, no excuses, start now! 

​<Name>, I have reviewed your Varicocele Risk Assessment (VRA) Form. You are definitely developing a serious condition here. A grade 1 varicocele with such serious symptoms... This is indicative of a combination of both risk from poor lifestyle and varicocele. Now, there is a lot to do here, and I'm very certain that my treatments will be helpful for you... So, I actually will recommend you to start with the 80 Day Complete Treatment Program, because that will be very helpful for your specific case: 
https://www.varicocelehealing.com/store/p142/complete-treatment-package.html

Now guys, this is a pretty old video that I made. I don't necessarily make the same recommendations now. But, here's a comment that I found very interesting.

Wrong. It is serious. It is toxic blood. This was not made to freak people out. It was made to provide 3 important treatments that can help with varicocele pain. Why do you think you have varicocele pain? You think it's aching or painful without reason? No. It's because your testicles and testicular veins are literally being damaged. The proper terminology for that is varicocele toxic blood pooling. The toxicities are from ROS damage, hyperhydration, lack of nutrient exchange, and yes, literally toxin buildup.

Actually, only about 15% of men with varicocele also have pain symptoms. That's not many. Some have severe pain, some have only dull aching pain. The condition varies in severity.

While you minify the pain symptoms for everyone else, I will note importantly that pain symptoms are an indication that your condition is worsening. Why? Because the damage done to your veins is damaging the vein valves. The pain means blood is blooding 70-100 time normal testosterone levels in your testicular veins--this means vein hypertrophy.

Now, while you pretend like nothing is going on, I urge all men with varicocele pain at least begin making specific lifestyle changes to address the root cause. I strongly urge men with varicocele pain to at a minimum adhere to the 3 pain relief treatments recommended here.

I have had too many clients who ignored their pain symptoms--who then later developed higher grade varicoceles and infertility. Scare tactic? If you want to call it that, go for it. I prefer to call it seeing reality, and doing something about it.

Here are 100 Free Treatment Tips. Stop being freaked out, and start doing something about your condition (Which is the #1 cause of male infertility... Not to scare you, but just share the fact). www.varicocelehealing.com/100-treatment-tips.