<s>[INST] Hi i have been punched in my lower back jus below my ribs. On impact i had an instany agonising pain shoot down my back and through my left leg. And since i have not been able to do anythin without it being extremely painful. Will this just be bruising or could i have damaged my kidneys. Its been 2 days now and even with pain killers the pain hasnt reduced [/INST] Hi, thanks for writing to Chat Doctor, As per your description your pain is due to a blunt impact on your back which is painful and also radiating to your leg. In this situation we need to see the site of impact of your lower back area for any local swelling, change in skin color, any bruising. If all of this is present then it is only a localized injury of your back muscles. Also since the pain is radiating into your leg the chances of back muscles spasms and inflammation are more. Chances of damage to your kidney are less but if you really want to be sure of it then an ultrasonography of whole abdomen will help you in doing that as it shows kidneys clearly. If the pain is due to previous reason of muscle injury(soft tissue injury) then localized hot water fomentation & rest should help you. Or you can take the help of your orthopedic specialist in this case. I hope this helps wish you good health </s>