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 PITTSBURGH (AP) -Washington Nationals right-hander John Patterson, out for nearly two months with a slow-to-heal nerve injury in his right elbow, is seeking treatment on his own in Toronto that apparently isn't approved in the United States.
After visiting four different doctors in Missouri, Texas and California last week - a trip Patterson himself arranged to learn what is causing the problem - Patterson will undergo a series of injections in Canada, according to the Nationals.
Asked why his opening day starter is going out of the country for medical treatment, Nationals manager Manny Acta said Saturday, ``It's because that treatment is not approved here in the States yet.''
Patterson and his agent made the decision to seek the unspecified treatment. The team would not elaborate on what type of injections the right-hander would receive or why he couldn't get them from a team physician or another doctor in the United States.
``The treatment is based on shots, injections,'' Acta said. ``Until he's done with all that treatment, we don't know'' what will happen next with Patterson.
With Patterson's course of treatment apparently not working - he has not had surgery - the team apparently is willing to let him seek additional options that might hasten his recovery and allow him to pitch again this season.
Acta expects Patterson to return this season, but has no idea when. Patterson started the season with a 1-5 record and 7.47 ERA in seven games, but hasn't pitched since May 5.
Patterson was pain-free after recently making two rehabilitation starts at Class A Potomac but, following a throwing session a week ago in Washington, said his arm still didn't feel right.
Patterson then went on his doctors tour and, according to Acta, all of those consulted agreed with the previous diagnosis of a compressed nerve in the elbow.
``I'm expecting him to come back, I just don't know when,'' Acta said. ``We'll go along with what we have here - I don't know if he's going to come back. I'm just going with what I have.''
Patterson, 29, is 18-25 with a 4.32 ERA in 88 games with the Diamondbacks, Expos and Nationals since debuting with Arizona in 2002. He had half of his career victories in 2005, going 9-7 with a 3.13 ERA with Washington.
Major leaguers haven't always gone along with conventional treatments for injuries. In 2004, outfielder Magglio Ordonez went to Austria to undergo shock wave therapy - a treatment once used only for kidney stones - on an injured knee.

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