Nick Pivetta struggled with his command in his first and possibly only rehab start in Worcester on Thursday night, walking four batters while being charged with four runs over three-plus innings against the Lehigh Valley IronPigs.

Having not pitched in a game since April 3 after being placed on the 15-day injured list with a right elbow flexor strain, Pivetta was rusty out of the gate. He walked the first two batters of the game and allowed five straight baserunners to open his outing.

Lehigh Valley’s Weston Wilson tagged him for a two-run single and then David Dahl singled to reload the bases and put Pivetta on the ropes, but then the right-hander asserted control and struck out the next three batters to escape the jam.

From that point on he got into a groove.

Pivetta easily got through the second inning on 10 pitches, drawing a ground out and two flyouts, and in the third he got two strikeouts and a lineout for a quick 1-2-3 inning on only 11 pitches. He then came back out for the fourth after an extended wait but had trouble finding the plate again, walking his last two batters before reaching his pitch limit and exiting for reliever Jorge Benitez. Both of his inherited runners later came around to score.

Pivetta finished the day with 62 pitches, 36 for strikes. He allowed three hits and struck out five along with the four walks and four earned runs.

Before going on the IL Pivetta had posted an 0.82 ERA over his first two starts of the season. Barring any unexpected developments the 31-year-old could potentially return to the big league club during next week’s road series in Atlanta.