West Ham United midfielder Mark Noble is having hernia surgery in Germany.
The England Under-21 international requires a double hernia operation after playing through the pain barrier for the last two months, and will be subjected to the procedure on Friday at the Munich clinic of Dr Ulrike Muschaweck, who has also treated Michael Owen and Noble's team-mate Craig Bellamy.
West Ham manager Alan Curbishley said: "Mark Noble had a hernia operation on Tuesday and while he was there, it was decided that he needed double hernia surgery.
"He is having the second one done tomorrow. He has been having this problem for a couple of months, but he didn't let on, and perhaps that is significant.
"I left Mark out of the team recently because I felt he was tired and perhaps needed a rest, and I remember him saying that rest was for the summer.
"But he has been going full pelt for the last five or six months, and not really had any recovery time, apart from two weeks off in the summer.
"We think he has a chance of playing in the Spurs game because of the techniques now, but he will take a bit longer to recover than Craig Bellamy, who needed only a week."
Noble's absence means Curbishley is now without 11 senior players, and his squad is looking ever-more depleted.
But the Upton Park boss refused to criticise Noble for his eagerness to keep playing.
Curbishley continued: "I think it's just natural - you're dealing with a young boy who just wants to play and thinks he can get through it.
"It's probably a little bit of naïveté from a young player who wants to play every week and is desperate to play for his club. We will put it down to experience."