Alvarez recently suffered a setback in his rehab program from his left elbow injury and is expected to undergo Tommy John surgery, Susan Slusser of the San Francisco Chronicle reports.

Alvarez was placed on the injured list July 7 due to elbow inflammation, only for the injury to later be diagnosed as an UCL strain. He elected to forgo surgery and was cleared to resume a throwing program earlier this month before experiencing the setback. Alvarez will likely seek a second medical opinion before deciding his next steps, but assuming Tommy John surgery is recommended, he'll likely go under the knife within the next few weeks. Alvarez has been ruled out for current season, and if surgery is indeed necessary, the reliever will likely be sidelined for the entire 2023 campaign as well.