<s>[INST] I am 30 yrs. old and have a horseshoe kidney, I also recently found out that I have a heart that beats too fast and high blood pressure. I have been somewhat healthy most of my life. 2 c-secs, 2 breast surgeries to drain and remove cycts and artificial ear drum as well as my tonsils being taken out, but other than all that pretty healthy. I was wondering I have had pretty bad back pain for a while now and it seems that the dr. cant find anything wrong from xray. I also had orthopedic surgeon check it out and they found nothing. I was wondering could this be from a complication of my horseshoe kidney. [/INST] Hi, I think renal complications may cause back pain. Renal complications are more particularly when you have a horse shoe kidney. Chances of urinary that infections are much more with horse shoe kidney. This may cause a lower back pain. Any form of glomerular disease should also be ruled out, particularly because you have back pain, horseshoe kidney and hypertension. As you have a normal X-ray and your orthopedic consultant has excluded any bony abnormalities, musculoskeletal reasons seem less likely. However, mechanical back pain, particularly due to faulty posture during sitting or standing or prolonged sitting or lax abdominal muscles may not display any clinical sign or imaging abnormality. Thirdly, a colonic pain may present similarly. Irregular bowel habit may or may not be associated with this. A fourtChatDoctormon consideration is pelvic inflammatory disease or endometriosis or any uterine abnormality. For the time being, my recommendations are-1. Urine for routine examination2. USG lower abdomen including KUB3. Plenty of oral fluid, preferably 3 lit per day.4. Analgesia with tab paracetamol 500 mg twice daily.5. Abdominal muscle strengthening exercise6. Continue with antihypertensive medication and cardiac medications. Few more information are needed regarding fever, bladder and bowel habit, pain abdomen for a more detailed answer. </s>