Ashley Giles will fly to Colorado today for an exploratory operation after suffering a recurrence of the pain in his right hip during Warwickshire's pre-season tour to Grenada.
A scan was inconclusive, but Giles hopes that the surgeon, Dr Richard Steadman who is respected as a leader in his field, may be able to offer some assistance.
"I've had some pain. As he was the guy who operated on me last time, I've got faith in him," said Giles. "Hopefully, he can shed some light on what is going on."
At present it is impossible to put any time frame on Giles' absence from the game. The hope is that the pain is nothing more than a normal reaction to a return to regular cricket after a long injury lay-off.
As Giles has already undergone two operations on his hip and another on his groin, however, there is a growing fear that this latest setback may prove to be the final chapter in a career of remarkable ups and downs. His body simply seems unable to take the demands of bowling and this latest trip to the US increasingly looks like a desperate last throw of the dice.
It is a cruel blow for a man who has worked so hard to regain his fitness. Life has thrown rather a lot at the Giles family in recent months and there appears to be no let up.
The news is also a severe blow to Warwickshire. Giles' all-round contribution would have given the side an enormous boost, though it does justify the club's recruitment of South African spinner Paul Harris. Alex Loudon will bear the brunt of the spin bowling duties until Harris arrives in June.
There was a clear emphasis on youth in the 12-man squad named ahead of tomorrow's opening championship game against Lancashire at Edgbaston. As expected, there was no place for veteran all-rounder Dougie Brown, but two other 30-somethings also miss out.
Luke Parker has been named to play ahead of former captain Michael Powell, while Naqaash Tahir, Jimmy Anyon and Tim Groenewald have been named ahead of Neil Carter.
The relative dearth of experience makes Giles' loss all the more serious. One of the young seamers is likely to be 12th man. Dale Steyn and Darren Maddy will both make their debuts.
* WARWICKSHIRE (from): D Maddy, I Westwood, J Trott, J Troughton, A Loudon, +T Ambrose, L Parker, *H Streak, D Steyn, Naqaash Tahir, J Anyon, T Groenewald.