Centre Manu Tuilagi's hopes of featuring in England's four home tests during the autumn internationals suffered a fresh setback after a recurrence of a groin injury.
The 25-year-old made his return to the England squad earlier this year in the Six Nations after a 15-month injury layoff and disciplinary issues.
However, his comeback was short-lived as Tuilagi was later forced to withdraw from the triumphant tour to Australia due to a hamstring injury.
Tuilagi missed his club Leicester Tigers' defeat against Wasps in the Premiership on Saturday.
"Last Tuesday his groin just started to tighten up," Tigers' director of rugby Richard Cockerill told British media.
"You can loosen it up and get out there in training, but what you don't want to do -- with his pathology and history with his groin -- is put him out there and suddenly it goes 'ping'. Then you are back to square one again."
"It's a short-term thing but we just need to get some definitives around it. You can take specialists', doctors' and physios' advice, but eventually it has to be about the player being happy and comfortable with it."
England host South Africa, Fiji, Argentina and Australia in November and December.
(Reporting by Nivedita Shankar in Bengaluru; editing by Amlan Chakraborty)