A "tennis elbow" has already forced One-day cricket's premier batsman, with a record 13,415 runs and 37 centuries, to miss three successive Limited Overs tournaments including the ongoing Champions Trophy in England.
With the series against Australia three weeks away, doubts have begun to creep into the minds of fans about whether Tendulkar will be available for all the four Tests.
Tendulkar is currently undergoing treatment in London. But Indian media reports quoted team physiotherapist Andrew Leipus as saying from London that he "was still in a lot of pain and unable to lift a bat".
Tendulkar was excluded by his state team Mumbai for the five-day Irani Cup match against the Rest of India starting in Mohali next week.
The only other first-class match before the Test series is the three-day tour opener at Hyderabad from September 30.
If Tendulkar is forced to miss that game as well, it would be a bold gamble by the selectors to pick him for the first Test in Bangalore from October 6.
The remaining three Tests will be played in Chennai (October 14-18), Nagpur (Oct 26-30) and Mumbai (November 3-7).
Tendulkar has not played a first-class match since the third and final Test against Pakistan in Rawalpindi in April, but neither has any other member of the current Indian team.
Sourav Ganguly's men have only featured in One-day tournaments since then in Sri Lanka, the Netherlands and England.
"It is a difficult situation as far as Tendulkar is concerned," said national selector Kirti Azad. "We are worried, the whole country is worried. It is an anxious wait to hear the good news about him."
Tendulkar told a television channel last week he was taking it "one day at a time. I am very, very disappointed at not being able to play for so long, but these things can't be helped," he said.
"All I know is that I am in good hands. It is too early to say when I will be back. I am taking it one day at a time."
Tendulkar's absence even for part of the series will be a big blow for the Indians who are aiming to win their third consecutive home rubber against the Australians after identical 2-1 wins in 1998 and 2001.
He has proved Australia's nemesis in previous home series, scoring 760 runs in seven Tests at an average of 63.
Tendulkar, who made his Test debut in 1989, has missed only one Test series in his 15-year career when a leg injury forced him to sit out the Sri Lanka tour in 2001.
He is the fifth highest scorer in Test cricket with 9,470 runs from 114 matches at an average of 57.39.