Howard attempted one shot and grabbed one rebound before leaving just 55 seconds into the game because of a twisted ankle suffered when he collided with Rockets guard Ty Lawson.
Howard, the NBA's third-leading rebounder, wasn't available to reporters after the game, but he was missed by the Rockets, who lost 123-114.
"He dominates the paint, so just rebounding, his offensive presence," said James Harden, who recorded a triple-double, the seventh of his career, in the loss. "Everything he brings to our team was missed."
Howard will be evaluated Thursday to determine if he can play Friday against Milwaukee.
On the season, Howard is averaging 14.8 points and 12.4 rebounds in 33.4 minutes per game. He has missed a total of six games this season, one for a league-mandated suspension and five others for maintenance for a tight back.
Yet Howard has played well of late and noted how healthy he has been. In the past 16 games, Howard has averaged 17.7 points per game and produced a 36-point, 26-rebound game in an overtime loss to the Los Angeles Clippers on Monday.
Against the Pistons and their center, Andre Drummond, the Rockets missed Howard's ability to consistently protect the rim.
"It was a huge difference, the way he has been playing for us," Rockets interim coach J.B. Bickerstaff said. "He's been impressive. He's been dominant, so you miss that, and your rotations are going to become shorter, especially playing against a guy like Andre."