Andy Murray says he would be "very surprised" to be fit for the French Open after retiring injured against Marcel Granollers at the Italian Open.
Murray looked troubled throughout and despite battling back to win the second set tie-break on the Rome clay, he then withdrew before the decider.
"Medical prognoses from players in the heat of the moment can prove unreliable, but Andy Murray's instinct is telling him that he's a serious doubt for Roland Garros.
"The decision to retire from the match came swiftly, and after his most inspired tennis, and he will now consult a range of experts before deciding whether the French Open is a realistic option.
"With Wimbledon and his US Open title defence on the horizon, Murray is concerned that a series of gruelling matches on clay could have even more serious long term repercussions."
"I pulled out because there was a good chance I would be playing tomorrow if I got through. As it is, I'd be very surprised if I was playing in Paris," said Murray.
"I need to make a plan as to what I do. I'll chat with the guys tonight and make a plan for the next few days then make a decision on Paris after the next five days."
The Scot's only previous mid-match retirement coincidentally came on his 20th birthday, when he snapped a tendon in his wrist at the 2007 Hamburg Masters.
That was the most serious injury Murray has suffered and led to him missing both the French Open and Wimbledon, and he will be hopeful of avoiding a similar fate this time.
Murray struggled with a lower back problem throughout the clay season last year, one match against Jarkko Nieminen during the French Open prompting former Wimbledon champion Virginia Wade to call him a "drama queen".
He had injections before Wimbledon but said the problem returned in Madrid last week and did not improve with rest. The situation became too much after two sets against Granollers on the Rome clay.
"Until Madrid it had been OK but it's not been perfect for a long period," he added. "You always go into matches with little niggles and such, but it's frustrating when for a long period you're hurting.
"It's been an issue for a while now and I want to make sure it goes away. It's not enjoyable when you're playing in pain."
Granollers, the world number 37, took the first set as Murray struggled to find any rhythm and things looked even worse for the Scot when he required on-court treatment after the third game of the second set.
Murray lost 10 consecutive points following his enforced break for treatment, but the British number one battled on and recovered from 4-1 down to level at 4-4.
Granollers broke Murray's serve in the ninth game but failed to serve out the match in the 10th, and as conditions become increasingly testing, with swirling winds whipping around the court, the set went to a tie-break.
Murray levelled the match when Granollers pushed a forehand long, before heading to his chair and informing the umpire he was retiring - to the amazement of his opponent and the Rome crowd.
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