CLEVELAND -- For most of this season, Dan Haren has been pitching with a stiff lower back. He hardly said a word about it, would vehemently deny it any time the topic was raised, and tried to pitch through it, hoping the extra therapy and exercises during the four days in between starts would be enough. He was just too proud.
Now, it seems, it's time to put that pride aside.
On Tuesday night, Haren was charged with seven runs, failed to pitch through five innings for the first time since May 8 and ran his ERA to 8.67 over his last four outings, leading to a 9-5 loss to the Indians and causing the Angels to reveal that Haren's back needs to be examined further.
In 12 years as a professional, Haren has never missed a start.
That streak is in serious jeopardy now.
"I'd go out and pitch with a broken arm if I could," Haren said after failing to notch a quality start for the 10th time in 17 tries. "But at some point, you're hurting the team rather than helping it."
Haren has been mostly hurting his team -- uncharacteristic as that may seem for a guy who was arguably baseball's most consistent starter for the previous seven seasons.
At a rainy Progressive Field, the place where he hurled eight one-run innings in late April, Haren's cutter continued to stay up, his velocity stayed down and he was hit hard from the get-go, on the way to six earned runs in 4 1/3 innings and an exit after just 69 pitches.
Haren is now 6-8 with a 4.86 ERA on the year, and he has given up 27 runs (26 earned) in his last 27 innings.
When the Angels get back home on Friday, they'll get doctors to examine Haren's back, making it highly unlikely that he will make his next scheduled start on Sunday. The hope is that the upcoming All-Star break will buy them some time, enough to avoid Haren's first disabled-list stint, but they just don't know yet.
"It's not so much that it's affecting my velocity, but it's not really allowing me to be able to power the ball down in the zone," Haren said. "I don't know. We need to get something figured out. We need to change course here, because it's been bugging me for a while."
Haren said the pain first began during his last start before the regular season, when he put the finishing touches on a Spring Training that saw him post a 2.05 ERA, strike out 25 batters and walk only two in 26 1/3 innings.
Since then, the 31-year-old right-hander said, it's been "an issue pretty much the whole year."
Haren was adamant that the back issues haven't affected his velocity, even though he's lost a couple ticks on his fastball and threw only one pitch above 90 mph on Tuesday. He hurt his back around Memorial Day last year, but that was a sharp pain that went away in about a week and only caused his start to be pushed back a couple days.
This is different.
"It's never been an issue like this," Haren said.
"It's getting to a point where I think we have to find out exactly what's going on in there," manager Mike Scioscia added. "He'll get evaluated when we get back to California, and we'll take it day by day."
Haren got ahead on 14 of the 22 batters he faced, but lacking sink, he left a lot of pitches up and it caused him to get hit around from the start.
Shin-Soo Choo led off the game with a triple and Jason Kipnis drove him in two batters later. In the second, the Indians took a 3-0 lead on a sacrifice fly by Shelley Duncan and an RBI double by Jack Hannahan. In the fourth, Duncan made it a four-run game on a towering solo shot to left field that went for Haren's 16th homer allowed.
The Angels used a five-run fifth inning off Zach McAllister to take their first lead of the game, getting a three-run homer from Mike Trout (his 10th) and a solo shot from Albert Pujols (his 13th).
But Haren couldn't hold it in the bottom half. He gave up a game-tying double to Jose Lopez before exiting with only one out, and sloppy defense caused the game to slip away.
Pujols fielded a Michael Brantley grounder and stepped on first base, then fired home across his body and threw wide. The ball bounced off the glove of catcher John Hester, who then flipped it to reliever Hisanori Takahashi at home in time. But the ball popped out of his glove while tagging Lopez, allowing a second run to score.
"It was a difficult play, going to his left, and he was trying to square up and they have speed at third," Scioscia said. "That was the only play Albert had, and he almost pulled it off."
After two more Indians runs and two more rain delays -- totaling an hour and 41 minutes -- the Angels moved to 5-3 on this road trip.
Where the road leads for Haren is still unknown.
Alden Gonzalez is a reporter for MLB.com. Read his blog, Gonzo and "The Show", and follow him on Twitter @Alden_Gonzalez. This story was not subject to the approval of Major League Baseball or its clubs.