That will hinge on his neck responding to a cortisone shot, injected on Monday (AEDT), that's supposed to alleviate the nerve irritation in 48 hours.

"I'm as disappointed as I possibly can be not to be able to pitch tonight," Scherzer said later, about two hours before the first pitch, as Joe Ross was down the hall preparing for the biggest start of his life. "It's game five of the World Series."

Cole, however, looked exactly like the pitcher who dominated baseball most of this season, bouncing back from a game one defeat to pitch the Astros just one win shy of a second World Series title in three years.

Yordan Alvarez and Carlos Correa each hit an early two-run homer off emergency starter Ross while George Springer added another post-season long drive, as Houston won their third straight at Nationals Park.

What a turnaround, too – outscored 17-7 overall at Minute Maid Park, Houston hammered Washington 19-3 at Nationals Park.

With the road team winning each World Series game to date, Houston will need to change that record to secure their title at home.

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Justin Verlander gets the first try when he starts against Stephen Strasburg in game six on Wednesday (AEDT).

Cole threw three-hit ball for seven innings, nicked only by Juan Soto's home run in the seventh, and struck out nine – eight on breaking balls.

"I just thought that we needed to execute better pitches this time out, and I didn't realise that that was how we got that many strikeouts," Cole said.

"I guess the situation just called for breaking balls in that spot. That's what we were feeling."

The Nationals must now win game six in order to force a game seven, which would also be played in Houston.

AP, with The Washington Post