Jordan Henderson, Andy Reid, Lee Cattermole and David Meyler are all out of Sunderland's trip to Arsenal at the weekend.
Henderson faces up to six weeks on the sidelines with an ankle problem while Reid will be out for the next month with a hamstring injury.
Cattermole and Meyler will both be unavailable in midfield as they start one and three-match bans respectively after being sent off in the 1-1 draw at bottom-of-the-table Portsmouth last week.
Things could get even worse for Black Cats boss Steve Bruce at the Emirates Stadium with Steed Malbranque unlikely to be risked after being taken to hospital complaining of chest pains after the Pompey game and Kieran Richardson battling to recover from a calf strain in time.
Defender John Mensah could be fit to return in defence after a hamstring injury but Anton Ferdinand is still struggling with an ankle problem as Sunderland bid for their first win in 13 league games.