<s>[INST] I fell very hard on tile floor when I slipped on water. My bottom hit very hard and now I have tremendous pain in the middle of my back. I really thought that it was my kidneys. There is no blood in my urine and no pain when I urinate but the pain is intense. What could be causing this mid back pain? [/INST] Hi,Welcome to healthcare magic.After going through your query I think You are suffering from acute backache after injury.Treatment of it is rest and analgesics . Diclofenac three times a day after meals is effective. Sometimes strong analgesic(such as ultracet three times a day after meals) is required. OMEPRAZOLE 20 MG before meals  prevent acidity caused by analgesics . There are three possibility ,one is simple muscle injury,second is disc prolapse and third is compression fracture of vertebra. To further investigate MRI of the region is advised. I think your query query answered.Welcome to any follow up query. </s>