Boston is 6-9 in its last 15 games and 2-3 on an important 10-game road trip. To make matters worse, the Red Sox have struggled against the Orioles, who beat them 7-1 in the opener of a three-game series on Tuesday at Camden Yards.
Baltimore is 12-5 in its last 17 games against Boston. The Orioles have won four of their last five series between the American League East rivals and can improve on that mark with a win on Wednesday night.
The Orioles are 8-2 in their last 10 games and have taken control of one of the Wild Card spots, but the Sox (57-60) are still holding out hope that they can save their season.
"I don't think anyone here, including myself, is already looking toward next season. I think we still have a shot," Red Sox catcher Ryan Lavarnway said. "This series and next series [in New York], if we can put a nice little run together, we still have a shot."
Aaron Cook returns to the Boston rotation on Wednesday for his first start since Aug. 6, when he beat the Rangers with seven innings of one-run ball. Cook takes the place of left-hander Felix Doubront, who has thrown a career-high 122 2/3 innings.
Cook meets the Orioles for the second time this season and would like to forget about his first meeting against them. In his Red Sox debut on May 5, Cook suffered a left knee laceration when he was cut while covering the plate, an injury that required stitches and a trip to the disabled list.
Miguel Gonzalez is scheduled to start for the Orioles. The right-hander is 4-2 with a 3.42 ERA since making his Major League debut on May 29. The rookie will make his eighth start and hopes to build off his Friday outing, when he allowed one run in eight innings to beat the Royals.
"I'm getting comfortable," Gonzalez said after his last start. "I stayed aggressive. I stayed in and out, changing pitches. That's what helped me out."
Red Sox: Bailey makes debut
Right-hander Andrew Bailey made his first appearance for the Red Sox when he entered Tuesday's game with two outs in the eighth inning. The reliever walked the first batter he saw before striking out Mark Reynolds.
Bailey had right thumb surgery the day before the season began and recently completed a Minor League rehab assignment. He was acquired from the Athletics in the offseason. He was a closer in Oakland but will likely pitch in high-leverage situations for the Sox while Alfredo Aceves continues to close.
"I have no expectations whatsoever," Bailey said. "We're at a point in time where we've got to start winning ballgames, and everyone knows that. For me, it's just whenever he calls upon me, that's when I'll go out and pitch."
The Red Sox traded backup catcher Kelly Shoppach to the Mets on Tuesday for a player to be named later. That opens the door for Lavarnway to get more playing time going forward.
Lavarnway started behind the plate on Tuesday and went 1-for-4, though he struck out looking with the bases loaded in the seventh. He was called up from Triple-A Pawtucket on Aug 1.
"Any opportunity that I can get to show what I can do is appreciated," Lavarnway said. "Shoppach is a good teammate. I tried to learn what I could from him while he was here. Now it's time for me and [Jarrod Saltalamacchia] to take the reins."
Orioles: Ankle injury sidelines Patton
Reliever Troy Patton was placed on the 15-day disabled list on Tuesday with a sprained right ankle. The left-hander said he rolled his ankle in a parking garage in Baltimore on Sunday night.
Patton had X-rays on the ankle on Monday, and the results were negative. He had a 2.58 ERA in 52 2/3 innings this season.
"[It's] very, very, very frustrating," Patton said. "I haven't felt as good as I've felt recently on the mound my whole career. So it's very frustrating. It's frustrating for this team and the situation we are in."
Patton was Baltimore's only left-hander in the bullpen, so the club traded for J.C. Romero on Monday help fill the void.
Rookie third baseman Manny Machado went 0-for-3 on Tuesday, his first game without a hit since making his Major League debut Thursday.
Still, Machado is 6-for-19 (.316) with three home runs, one double, one triple and seven RBIs in five games.
The Orioles are 3-2 since Machado joined the club.
Red Sox second baseman Dustin Pedroia is riding a nine-game hit streak. He went 2-for-4 on Tuesday with a double and a triple. Pedroia is hitting .388 (19-for-49) in 13 games this month with 11 runs and four RBIs.
The Orioles have won 11 straight one-run games dating back to June 22, one victory shy of the franchise record last set in 1979.