Inzamam also missed the second Test in Melbourne with a back complaint but was hoping to return in Sydney as the injury showed signs of improvement.
However, Inzamam's hopes were dashed after he was put through a rigorous practice session at the nets on Saturday, leaving the tourists in further disarray.
"We can't even name a team yet," stand-in skipper Yousuf Youhana told reporters on Saturday.
"We have to replace four players. There will be a lot of changes."
Abdul Razzaq was also ruled out after being taken to hospital during the Melbourne Test with a mystery illness. He was later discharged with a clean bill of health but management left him out after he complained of feeling dizzy.
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Yousuf admitted the odds were heavily stacked against his team winning.
"Australia don't take it lightly and we don't either," he said.
"I know they're better than us because we have a lot of young and inexperienced players but we're still trying to win this game."
Australia easily won the first two Tests to take an unassailable lead into the final game.
However, captain Ricky Ponting said they were not treating their opponents lightly.
"I hope they're competitive," Ponting said. "There were times in the first two Tests when they had us in trouble but they weren't able to maintain the pressure and that is the main difference between the teams.
"It's another opportunity for us to improve ourselves as a team and win another Test match. We don't ever see any game as being a dead-rubber.
"At no stage now are we going to take our foot off the accelerator."