The match gets underway on Thursday but Woakes missed training on Tuesday, due to the return of pain in his right thigh.
The same injury kept Woakes out of England’s limited-overs campaign this summer, before he returned with a man-of-the-match performance in the Lord’s Test.
Woakes hit 137 not out and took four wickets as England won by an innings to claim a 2-0 series lead, before India hit back by winning the third Test at Trent Bridge.
The Warwickshire man is now a doubt for the Ageas Bowl this week and an England and Wales Cricket Board spokesman said on Tuesday: “Woakes has tightness in his right quad and will not train today.
“We will take a view where he is at tomorrow.”
England are not yet planning to call up anyone as cover.
Sam Curran, who impressed in the first two Tests before being left out at Trent Bridge, had been tipped for a possible recall and would be a likely replacement if Woakes misses out.