Nicky Hayden may be forced to withdraw from the Italian Grand Prix as he struggles with an injury to his wrist, the American revealing he will almost certainly undergo surgery on it regardless.

The American has been suffering with pain to his wrist since the Spanish Grand Prix a month ago when he 'irritated the joint' during qualifying at Jerez, but did reveal the wrist has arthritis in it.

Indeed, while he struggled on in Le Mans in the hope the break between races would allow it to heal sufficiently, he says the demanding characteristics of Mugello are creating new issues.

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Completing just a handful of laps in the dry FP1 session, before a cautious run in the damp FP2, Hayden has hinted he may withdraw from the remainder of the event with a view to undergoing surgery as soon as possible.

"I think we are going to sit out the rest of the weekend," he said. "It wasn't great at Le Mans and the crash didn't help, but this track is a different level.

"I had a lot of pain in my hand. I thought the break after the last race at Le Mans would be enough for me but here the problem is worse. I worked really hard last week to try and recover with different kinds of therapy and a hyperbaric chamber but the injury to my right wrist has not improved.

"In France I was able to ride through the pain but this circuit is much faster and more demanding.

"After talking to the doctors it seems the smartest move is to undergo surgery next week in order to be fully fit again as soon as possible."