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Kansas City Royals starter Seth Lugo has suffered a setback.

On Tuesday, Royals manager Matt Quatraro said Lugo’s back flared up again during a recent bullpen session. A low back strain had sidelined him on the 15-day injured list earlier this month.

“He didn’t come out of his bullpen yesterday very well,” Quatraro said. “So, he is going to be day-to-day. It’s going to depend on the symptoms as to when he starts getting back into throwing.”

The Royals are hopeful Lugo can pitch again this season. Quatraro said Lugo tried to throw an aggressive bullpen to be available for Thursday’s series finale against the Seattle Mariners at Kauffman Stadium.

The symptoms were still prevalent and that forced the Royals to look for an alternative option. As a result, the club decided that right-hander Stephen Kolek will start in his place.

“Now we have to wait for the symptoms to resolve or to at least diminish enough to where he can go up and be competitive throwing,” Quatraro said. “So we really don’t know what’s going to happen. You know, it just happened yesterday and he came in today pretty sore. We have to see how it goes.”

Lugo has posted a 4.15 ERA in 26 starts this season. He recently signed a two-year contract extension with the Royals but has struggled since late July. In his last nine starts, he has posted a 7.51 ERA in 44 ⅓ innings.

Injuries have also hindered his season. He dealt with a right middle finger sprain in May and now the back strain in September.

“It’s concerning but we know it’s not a career-threatening type of thing,” Royals general manager J.J. Picollo said. “It’s just something that is nagging him and he is not ready to come back. So just gotta give it another couple of days, see how he feels and figure out if he can make a start next week.”

Time is running out. The Royals enter Wednesday with 11 games remaining this season. While Lugo is sidelined, the Royals did get back fellow starters Michael Wacha and Cole Ragans.

Wacha didn’t fare well in Tuesday’s series opener against the Mariners. He allowed seven earned runs in 2 ⅔ innings. Ragans, meanwhile, is slated to start Wednesday night at Kauffman Stadium after a long layoff nursing a left rotator cuff strain.

The Royals are hopeful to see all three starters return in the final stretch. Regardless of if they can make a miracle playoff push, the Royals want to have their top pitchers finish the season on a high note.

“To have Michael back today and Cole tomorrow, that’s good for us,” Picollo said. “They are the horses in our rotation and it’s good to have them back.”