England's bowling concerns mounted on a tough third day of the first Test in Antigua, as Mark Wood was all but ruled out of the attack for the remainder of West Indies' first innings after complaining of soreness in his right elbow.

Wood, England's fastest bowler and the man on whom their hopes of breakthroughs might have been pinned on a sluggish surface at the Sir Vivian Richards Stadium, had been a late arrival in the morning session after receiving strapping on the injury.

He bowled four overs with the old ball prior to lunch, conceding back-to-back boundaries from short balls as West Indies' centurion, Nkrumah Bonner, capitalised on his relative lack of pace - with his average speed dipping from 89mph on day two to 85mph - then retreated from the field for the rest of the day after just one more over with the new ball, in which Bonner launched him over fine leg for the only six of his nine-hour innings.

The nature of Wood's injury will be a particular worry for England, given that it was elbow soreness - later diagnosed as a stress fracture - that caused England's other 90mph spearhead, Jofra Archer, to undergo two operations in 2021, the second of which is likely to keep him out of action at least until May.

After an injury-plagued start to his Test career, including three ankle operations in the space of 12 months in 2016, Wood has enjoyed a sustained run of fitness in recent times - partly attributed to his decision to revert to a longer, smoother run-up after a sprinter's style approach in his early years. He was England's stand-out bowler in an otherwise dismal Ashes series, claiming 17 wickets at 26.64 in four Tests, making this the busiest winter of his 26-Test career.

"It's pretty sore at the moment," Paul Collingwood, England's interim head coach, said, adding that it was an issue that Wood had not previously encountered. "We're going to have to assess him overnight and see if he is going to be available for the second innings

"I'm not too sure [what it is], all I know at this moment is it's soreness in the elbow. He didn't feel that confident this morning and but then he got it strapped up, and it felt okay. Then he tried another over in another spell and it didn't feel so good. We'll get the anti-inflammatories into him overnight, get him iced up and see how he is tomorrow.

"You need those kind of guys, 90mph guys who can reverse-swing the ball in these conditions. They are gold dust in these conditions. So it will be disappointing if he's not involved in the second innings, but we'll have to wait and see."

In Wood's absence, it was a day of hard toil for the remaining members of England's attack as West Indies closed on 373 for 9, a lead of 62. The recuperating Ben Stokes took up much of the slack, even though he had not been intended as a frontline option as he continues his comeback following the side strain that hampered his Ashes campaign. In the end, Stokes was called upon for 28 overs, his heaviest innings workload since 2015, and ended up being the pick of the seam attack with 2 for 42, including the big scalp of Jason Holder for 45 in the morning session.

"It's fair to say that he declared himself fit to bowl in this first innings," Collingwood said. "None of us were expecting that many overs out of him. Obviously we had to be pretty cautious with the approach but then, Ben being Ben, he went out there, and felt great. He's done everything so far on this tour to get himself fit. His attitudes has been absolutely superb. And he's shown today what kind of a warrior he is."

That determined attitude, Collingwood said, was applicable to the remainder of England's team. "Today was probably one of the best efforts I've seen in England shirt and Test cricket," he said. "To go for 170 runs and five wickets on that today is a pretty good effort, especially backing that up from two sessions in the field yesterday. I thought the fitness levels the guys showed, the attitude in the field was exceptional.

"If you know anything about cricket, then you'll realise how that pitch is playing. It was tough, hard work out there. It's a placid pitch. It's a docile pitch. I think all of us expected it to break up a lot more than it has done and start turning. Sometimes you can look at the scoreboard and see you haven't bowled them out but I thought the attitude was superb today."

Despite Collingwood's positive assessment, Wood's injury comes at an especially awkward time for England's management, given the controversial decision to omit both of their talismanic attack leaders, James Anderson and Stuart Broad, from this tour - ostensibly with a view to giving the less-heralded members of the bowling unit a chance to lead the line.

One of those, Ollie Robinson, finished the Ashes under a fitness cloud and was not available for the first Test after succumbing to a back spasm during England's solitary warm-up match. In his absence, Chris Woakes and Craig Overton - England's preferred new-ball pairing - returned the combined figures of 61-13-169-3 over the two days of West Indies' innings, having been taken at nearly four runs an over by the opening pair, Kraigg Brathwaite and John Campbell.

With a short turnaround between the three Tests, England may already be bracing for Wood's absence in Barbados next week - and if Robinson is not ready for a return, the likely replacement would be Lancashire's seamer Saqib Mahmood, another 90mph prospect, but who has yet to make his Test debut.

Matt Fisher, the uncapped Yorkshire seamer, is also on the tour, while Warwickshire's Liam Norwell is understood to be among the players on England's reserve list. Matt Parkinson, the legspinner, is England's other bowling option on tour.

Broad and Anderson, however, are not expected to be called up as reinforcements, with Collingwood stating after Robinson's injury last week that England were "not about to panic".

"Ollie is making great progress," Collingwood said. "He bowled a good spell this morning and he'll have a couple of spells tomorrow. I'm hopeful that he can be there and thereabouts for the second Test."