Much of their strange campaign this season has been ravaged by absentees, most notably in defence when most of the back line and the goalkeeper were sidelined.
Now, before facing Manchester United in their biggest game since the Champions League final in 2019, Spurs have a midfield problem and a creative one at that.
Last week, Dejan Kulusevski underwent surgery after sustaining a knee injury in the first half of Spurs' defeat to Crystal Palace, curtailing his season early.
James Maddison is also on the treatment table with a knee issue, while Lucas Bergvall sustained ligament damage to his ankle during a training session.
Not having that trio takes away a huge amount from Ange Postecoglou's team, and to say it leaves a void would be an understatement.
Kulusevski, in particular, is a huge miss, despite his recent fitness issues, considering he has created the most chances of any Spurs player with 86 across all competitions and the most shot-creating actions (156).
But, while it will put a dampener on things before a ball has even been kicked in Bilbao, all is not lost.
The timely return of Son Heung-min is a plus given what he can do on the wing, but the Spurs captain is still working his way back up to full sharpness, so questions are raised there too.
Tottenham should now look in the direction of Pedro Porro for some inspiration, having been one of their bright spots this term.
Incredibly, the Spaniard has been a constant for Spurs this season by somehow avoiding any injuries when the rest of his teammates picked up problems.
Porro has offered Postecoglou a different source of attacking threat from right-back, and he will have more eyes on him this coming Wednesday.
He only ranks behind Kulusevski for chances created (77) and has the third most shot-creating actions (149), trailing the Swede and Son marginally.
These kinds of numbers don't surprise, though, given Porro's security on the ball and technical ability, particularly when allowed space.
Crossing could become the route of a Spurs goal, and with a ball-winning midfield of Rodrigo Bentancur, Yves Bissouma and Pape Matar Sarr expected, it could allow Porro the license to get forward.
No Spurs player has fired more crosses into the box from open play than Porro (186), so it could be viable with Dominic Solanke to aim at and even Richarlison if he's handed a start.
But there have been instances where Porro has taken the more direct route and showcased his ability to pick out a long pass for someone like Solanke to chase.
Not only does it get Spurs further up the pitch from a defensive perspective, but it stretches the opposition by having them backpedal.
Postecoglou will no doubt recognise the importance of Porro and what he brings, even flirting with the idea of deploying him as a midfield playmaker.
"No, I think it's all in the realms," Postecoglou said when asked of that possibility. "When you're in this position, you go through all the different scenarios. You consider it all.
"At the same time, even if you do something radical, whether it's a positional change, it's always better done in the confines of having a real solid foundation there."
It would definitely be a bold move, and with the bodies missing, Postecoglou would be right to consider all of his options.
Yet is it the correct time to experiment? Probably not. After all, a central midfield role comes with very different duties and challenges on its own. There's much less space in the middle, and Porro's best work comes with a bit of room out wide, where he can fully face the play.
It does seem like there will be a reliance on Porro to conjure up something in Wednesday's final, but that is a responsibility you'd expect him to take in his stride.