WASHINGTON -- When Max Scherzer woke up on Sunday morning, he couldn’t get out of bed. The pain in his neck and right trapezius muscle was so intense that he had to fall out of bed and pick himself back up. Scherzer realized he couldn’t lift his right arm. His wife, Erica, had to lend a hand just so he could get dressed.

• World Series presented by YouTube TV, Game 6: Tuesday, 8 p.m. ET on FOX

Scherzer knew in those moments that there was no way he would be able to take the mound later that evening for Game 5 of the World Series against the Astros. Even hours later, as he sat for a news conference, he moved gingerly, turning his whole body completely to answer questions and barely moving his head and neck. On his way to the park, Scherzer texted Joe Ross to let him know to get ready to start in his place.

And then Nationals manager Dave Martinez began his pregame news conference with the stunning announcement that Scherzer had been scratched and Ross would start in his place.

“I'm as disappointed as I possibly can be not to be able to pitch tonight,” Scherzer said. “It's Game 5 of the World Series. I've pitched through so much crap in my career that that would be easy to pitch through at this point. This is literally impossible to do anything with.”

Ross, who entered Friday's Game 3 in relief and tossed a scoreless seventh and eighth, held his own over five innings in the emergency spot start, but he allowed a pair of two-run homers as the Nationals fell to the Astros, 7-1. Washington now faces a 3-2 deficit in the best-of-seven World Series, as the scene shifts to Houston for Game 6 on Tuesday.

It marked Ross' second postseason start. His first was in Game 4 of the 2016 National League Division Series vs. the Dodgers. Ross finished the '19 regular season strong, going 4-1 with a 2.75 ERA in his final eight appearances, all starts.

"We kind of gave him a heads-up last night," Martinez said of Ross, who allowed four runs on five hits while walking two and striking out one. "And when he came in this morning, we told him he was definitely going to start.

"I thought he did really well, I really did. I told him, hey, we want to keep him right about 80 pitches, and he gave us five good innings. And I said, 'Hey, you need to be ready to pitch in a few days again.' I said, 'You did a great job.'"

"Joe has kind of done a little bit of everything this year. He's such a great competitor," Game 2 winner Stephen Strasburg said on Sunday. "He's such a great athlete. I trust his ability to prepare. I think that's one thing that having some of the struggles early on in the year with him, he really took another step as far as like preparation, doing his homework, and you just take notice of those things."

On Sunday, the Nats remained optimistic that Scherzer would be able to pitch again this year. Strasburg is still scheduled to start Game 6 on Tuesday night, and if Scherzer improves, he could be available in relief or to start a potential Game 7 on Wednesday.

"He's going to figure something out," Martinez said. "Right now, I don't know his status. I'll find out when I go back in. But he's going to try and get himself ready."

Scherzer, 35, received a cortisone shot on Sunday morning, and team doctors told him that it would take about 48 hours to kick in. He was concerned for a bit about the long-term effects of the injury, but doctors informed him that as long as he didn’t have numbness coming down his arm, there shouldn’t be any serious long-term damage.

“That's what the doctors believe,” Scherzer said. “With this nerve irritation ... they think with the cortisone shot in there, that the 48 hours really helps decide the pain that's being alleviated -- alleviate the pain from that neck nerve that's in my neck right now that's all pinched up.

“So for me, I'm just hoping that the doctors are right and that something could be possible for Game 7.”

As Scherzer sat at the podium, however, struggling to move his body, he did not look like a pitcher who would be ready to take the mound in a few days, nor one who would be at full effectiveness if he did.

Scherzer’s injuries do not appear connected to the back and shoulder injuries that landed him on the injured list earlier this season. Then, it was a strained rhomboid muscle and inflamed bursa sac that prevented him from pitching, whereas this issue seems more focused on his neck.

Scherzer started feeling spasms a few days ago, but he had dealt with that in the past, so he figured he could shake it off. He received treatment a few days ago, and usually hitting can help loosen his body up, but things still didn’t feel right after some swings in the cage. Scherzer still remained hopeful when he went to bed on Saturday night, but when he woke up, his neck felt locked up.

“This is just a little thing that turned into a big thing that turned into a giant thing,” Scherzer said.

Consider just how significant the pain must be for Scherzer to miss a World Series start.

Scherzer is perhaps the most competitive player on the Nationals, especially on the field, but also in everyday activities. He’s gone viral for yelling at managers during mound visits to let him remain in the game. On June 19, one day after breaking his nose and suffering a black eye on his own foul bunt attempt in batting practice, Scherzer demanded to make his start that evening in the second game of a doubleheader. During the second half, when his season was interrupted with injuries to his back and shoulder, he walked through the clubhouse often in such a surly mood that Martinez multiple times described him as “a little ornery.”

Now, with a chance to give his team an edge and put it on the cusp of a World Series championship at Nationals Park, Scherzer was stuck watching the loss from the dugout, hoping for a Game 7 -- and hoping he will feel good enough to pitch in it.

"He was upset," Martinez said. "Max is very -- he likes to talk. He's very competitive. Today was the first time I think since I've known him that he didn't say much. He was quiet. And I knew that he was in pain."