Winks slipped off the Turf Moor pitch after what appeared to be an innocuous challenge but was soon clutching his left leg in a serious degree of pain.
The Burnley medical staff rushed to the youngster's aid, as he fell directly in front of their seats, and Winks received oxygen on the side of the field as he was attended to.
Winks had to be stretchered off the field of play but it remains unclear as to what injury he suffered, but the reaction of the medical staff suggests was a worrying sign.
The midfielder's leg appeared to buckle before he fell to the ground and the anguish etched across his face was a worrying sight for Spurs fans.
If Winks's season over it will be a cruel blow to a player who has to bide his team before being given regular game time under Mauricio Pochettino this season.
The 20-year-old was subsequently replaced by Moussa Sissoko on the stroke of half-time, having already lost fellow central midfielder Victor Wanyama to a back problem.
The Kenya international initially tried to carry on after suffering a knee to the back but was replaced by Mousa Dembele after going to ground a second time.