"He's going to go to see Dr. Andrews, and we'll see what's going to be in his best interest, whether it's a surgical or non-surgical procedure," Miami manager Dan Jennings said.
Since 2013, Alvarez has served four DL stints with right-shoulder inflammation, including two this year.
An All-Star in 2014, Alvarez was Miami's Opening Day starter this season, but he hasn't been right all year, posting an 0-4 record with a 6.45 ERA in four starts.
Initially, he was placed on the DL on April 13, and on May 17, he was back. But after two starts, he went back to the disabled list.
The Marlins were hopeful Alvarez would return in August. The right-hander was sent on a rehab assignment with Class A Advanced Jupiter on July 15, and he was recalled from the assignment on July 22, after experiencing discomfort in a between-starts throwing session.
Alvarez was acquired by the Marlins as part of the 12-player deal with the Blue Jays after the 2012 season.
He opened 2013 on the disabled list with shoulder inflammation. On the last game of that season, he no-hit the Tigers at Marlins Park.
On Aug. 1, 2014, he also went on the disabled list with shoulder inflammation.
Alvarez has been dealing with a shoulder issue, but he's also been pitching with a partial elbow ligament tear for years.
Joe Frisaro is a reporter for MLB.com. He writes a blog, called The Fish Pond. Follow him on Twitter @JoeFrisaro and listen to his podcast. This story was not subject to the approval of Major League Baseball or its clubs.