FORT MYERS, Fla. — The natural tendency would be to look at the fact that J.D. Drew was flown to Boston to receive a pain-killing injection in his lower back and conclude that trouble’s a-brewin’.

Clearly, the starting right-fielder has yet to answer some of the injury questions that plagued him last year, and for that matter, throughout his career. As such, there will be questions about his ability to stay in the lineup that, in turn, will play into broader uncertainties about the Red Sox lineup.

That list of doubts is by now well known. There’s no middle-of-the-order Mark Teixeira or Manny Ramirez. David Ortiz and Mike Lowell join Drew as players whose production was diminished last year by injuries. There are issues with the team’s production up the middle, where catcher (Jason Varitek), shortstop (Julio Lugo and Jed Lowrie) and center field (Jacoby Ellsbury) offered little by way of offense in 2008.

Drew produced outstanding overall numbers while playing last year, hitting .280 with a .408 OBP, .519 slugging mark, 19 homers and 80 RBIs. But he managed to play in just two-thirds of regular-season contests (109 games).  The Sox have already told Drew that he’s a difference maker whom they want to keep in the lineup.

“What we talked about with J.D. in our meeting was that when he’s on the field, we’re a different team,” Francona said. “There’s no getting around it. Whether he’s hitting fifth or whatever, and playing right field, we have a different look.”

That being the case, does Drew’s roundtrip to Boston to receive a facet joint injection from Dr. Bill Palmer represent cause for alarm?

Not quite.

The Sox insist that the shot is not a major event, and that Drew has not been limited in his baseball activities this spring. Yet based on the evidence of last year, even if Drew ended up missing time – perhaps even a significant number of games – there’s little reason to suggest that the Sox will necessarily struggle in his absence.

THE HEALTH OUTLOOK

The Sox and Drew both downplayed the significance of the pain-killing injection – a facet block that also included some cortisone.

"(The shot was) really a win-win situation. I mean, if it doesn't go well, then it's not a big deal. If it goes well, then we kind of get an idea of what's going on,” Drew told NESN. “Been working with a chiropractor. Started talking a little bit about some of the underlying issues and thinking that the facets might be a little bound up. So (I) talked with the training staff a little bit, decided to do an injection in that area to see if that would free up some of the old scar tissue, an old injury, and give me some freer motion in that area.”

Francona noted that Drew had been smoking the ball in batting practice this spring. He has not been limited in his ability to take part in baseball-related activities. The manager suggested that the Sox were using the meaningless exhibition season to try to identify a solution should Drew’s back act up during the regular season.

“I don’t want to get this confused with he did something with his back,” said Francona. “I think it’s something more for, if down the road, if it sort of acts up, we want to see if this is the right thing to do … If we run into a problem later this year, maybe we know a little bit quicker where to go.”

That was in part due to the fact that the team’s efforts to treat Drew last year did not prove fruitful. The outfielder told NESN that the two epidural injections he received in 2008 didn’t help to alleviate pain in his lower back or return him to the field any faster. If Monday’s injection proves effective, then the Sox will hope that they have a means of quickly getting Drew back in the lineup should a recurrence of the discomfort impair him during the year.

All the same, the fact that the team wanted to explore potential ways of treating Drew during the season offered a reminder that the outfielder is not pain free. For the sake of argument, then, it seems worth considering the impact of Drew’s absence from the lineup.

THE RED SOX WITHOUT DREW

Francona’s suggestion that the Red Sox are a different team with Drew on the field is a natural one. The 33-year-old gets on base, hits for decent power and covers a lot of ground in Fenway Park’s expansive right field.

Somewhat surprisingly, however, it was difficult to see where his absence hurt the club last year. The Red Sox went 59-48 (.551) with Drew in the starting lineup last year. They went 36-19 (.655) when he was sidelined. They scored more runs per game (5.38 to 5.13) and allowed fewer runs per game (4.13 to 4.36) when he was out of the lineup than when he was in it.

That included the stretch from August 17 through the end of the year, when Drew made just two starts, Ramirez had been replaced by Jason Bay and Ortiz and Lowell were playing hurt – when they were playing at all. The Sox were expected to struggle offensively. Instead, the Sox went 24-14 (the second-best record in the American League) and averaged 5.47 runs per game.

The notion of Drew’s transformative impact on the lineup may have been exaggerated by his obscenely good June. Then, without Ortiz in the lineup, Drew virtually carried the Sox, hitting .337 with a .462 OBP, .848 slugging mark and hitting 12 homers while driving in more than a run per game (27 RBIs in 26 contests).

But the rest of the year, he was a good player, rather than an irreplaceable one. In the non-June months of last year, Drew hit .261 with a .390 OBP, .409 slugging percentage and .799 OPS. Those numbers were fairly similar to the full-season production in 2007 (.270 / .373 / .423 / .796) that had the bust label attached to Drew in his first year in Boston.

Clearly, none of this suggests that Boston is a better team without Drew than it is with him. He remains a talented player with a diverse set of skills that can help the club in a number of different ways.

All the same, the Sox possessed the necessary depth to withstand Drew’s absence in 2008 without getting derailed. That being the case, it seems premature to anticipate that a pain-killing injection in the early days of March represents a potentially devastating blow to the team’s fortunes in 2009.