Ashes winner Chris Tremlett may need surgery to cure the back problem which forced him out of England's ongoing Test series against Pakistan in the United Arab Emirates.
Fast bowler Tremlett had to fly home before the second of two successive defeats to date, having added just one appearance since the same problem ruled him out of last summer's Trent Bridge Test against India and then for five and a half months afterwards.
The 6ft 7in fast bowler, who took 17 wickets in three Tests in England's historic Ashes victory in Australia last winter, is suffering with a back problem which has been described as "chronic" by medical specialists.
The England team's physiotherapist Ben Langley told The Sun: "Scans have revealed various issues with Chris' back - but we have to find out exactly what is causing the current problem.
"He will see two specialists to get two opinions. The programme he followed after breaking down last summer has not worked, so he might have to go down the surgery route."
Thirty-year-old Tremlett has fallen prey to injury several times since making his Test debut against India five years ago.
Langley added: "If Chris does need an operation, we are hopeful he will be able to bowl again in the future.
"He is a very calm man, who has taken all his injury frustrations in his stride.
"He always does his rehab very diligently so he will certainly give himself the best chance of a full recovery."
Tremlett's injury is one of several to hamper England's pace-bowling resources of late.
Stuart Broad is fit again, but spent last autumn resting a shoulder problem; Tim Bresnan also flew home from the Middle East last month with post-operative elbow pain, and his participation in the forthcoming limited-overs leg of England's tour remains in doubt - and only yesterday, Stuart Meaker had to leave the Lions tour of Sri Lanka.