Japan coach Takeshi Okada could rest Nakamura for Sunday's qualifier against Bahrain, which will decide which of the teams finish top of their preliminary group.
Both are certain to qualify for the fourth stage of qualifying, so Nakamura does not need to be involved, but the 29-year-old wants to play and help Japan climb above Bahrain, who have a one-point lead going into the final Group 2 game.
He needed a painkiller to feature in the Thailand game and may require another to start against Bahrain, who surprisingly beat Japan in Manama in March.
"The coach is thinking about resting me," Nakamura said. "But the ankle could heal by the weekend."