Yet, it remains an emotional and key game that will go a long way in deciding this year's AFC North championship.
Baltimore's defense ranks 27th in the league in yards allowed per game and are 26th in both run and pass defense.
The primary problem against the pass is that they've only generated 16 sacks and allow 11.8 yards per catch. Against the run, the Ravens allow an uncharacteristically high 3.9 yards per carry. Last season they led the AFC by yielding only 3.5 yards per carry.
Injuries have taken a toll, and Lewis isn't the only one. He's on injured reserve (designated for return) because of a torn triceps and been replaced by Dannell Ellerbe outside as Jameel McClain moved inside.
The Ravens also played last week without All-Pro defensive tackle Haloti Ngata, who had been struggling with shoulder and knee injuries but practiced this week and told the Baltimore Sun, "It was a great week."
But it wasn't a great week for Jimmy Smith, who underwent surgery for a sports hernia. The 2011 first-round draft pick had replaced Lardarius Webb at cornerback when Webb was played on injured reserve. Instead, the Ravens will turn to Corey Graham opposite Cary Williams. Graham was acquired as a free agent in the offseason because of his special teams work with the Chicago Bears. The No. 3 cornerback will likely be novice Chykie Brown.
The Ravens aren't getting much production from Terrell Suggs, either. The pass-rusher with 18½ career sacks against the Steelers has only 1 sack in 3 games sincer coming back so soon from a torn Achilles' tendon this offseason.
But in spite of the injuries, and the bleeding of yardage, the Ravens still make it difficult to score. They're 13th in the league in points allowed thanks to the top-ranked red-zone defense.
"I think they're playing great," said Steelers guard Willie Colon. "Obviously, Ray's their emotional leader. They get charged up with him in the game. But their inside backers are playing at a high level.
"We just have to flat go out and play. We're not going to do anything different. I'm pretty sure they're not going to do anything different. It's going to be man on man and everybody's will is going to be tested."
Can the Steelers score against the Ravens with Byron Leftwich at quarterback?
Leftwich will play without Pro Bowl wide receiver Antonio Brown but will have running back Rashard Mendenhall back in the backfield. No matter who's been rushing the ball, though, the Steelers have averaged 140 rushing yards per game and 4.7 yards per carry the last four games after averaging 75 per game and 3.0 per carry in the first five.
But will that running game – or the entire offense in general – slow to a crawl without Roethlisberger?
The Steelers don't think so, and they promise it's not just optimistic spin.
"It's too good of a rival to have it affect us," said left tackle Max Starks. "The biggest thing is we've battled a lot of adversity through the years at different positions, losing guys for the year. I think having an injury happen to our quarterback is a blow because that's a leader. He's obviously the franchise here. He's the heartbeat of the offense. But I think the biggest thing is knowing the guys you have behind him. It's not like we're using a fresh rookie who just got drafted and has never taken a snap in the NFL. I mean, we have grizzled veterans who have been through the trenches, who have been starting quarterbacks on other teams, who have started here at different points. So they have that experience and there's a comfort level."
Even if Roethlisberger is out for the remainder of the season, Starks and the Steelers believe they can win the division, even a Super Bowl.
"No question," Starks said. "I don't have a doubt in my mind. I could see if it was a rookie, second-year guy – ahhhggghhh – you'd be worried. But the youngest quarterback we have is Ben. So I feel really confident. We have a 10-year guy and a 15-year guy who've seen everything. There won't be any surprises. We won't be caught off guard."