No. A heel spur is extra bone on the heel; plantar fasciitis is pain and thickening in the tissue that attaches there. They often appear together because both come from long-term load through the same point, but you can have one without the other. Treatment for both targets the soft tissue and the load going through it, not the bone itself.

Rarely. Most heel spur pain settles with non-surgical care, because the spur is usually not the structure generating the pain. Surgery is generally considered only after a long period of well-directed treatment has not worked, and it is a decision made with an orthopaedic specialist. Your podiatrist can arrange a referral if that point is reached.

Usually not. Bone does not dissolve once it has formed, so the spur often stays visible on imaging even after your symptoms have gone. That is not a sign treatment has failed. Plenty of people walk, run and work with a spur on X-ray and feel nothing at all, because the tissue around it is coping with the load again.

Yes. Spurs can form at the back of the heel where the Achilles tendon attaches, and they behave differently to the ones underneath. Back-of-heel spurs are often linked to tendon changes and pressure from shoe counters and heel tabs. The exercise plan and the footwear advice both change, so it is worth having the location confirmed.

In most cases yes, with adjustments. Complete rest tends to make the tissue less tolerant, not more. Your podiatrist will usually set a level of walking or running you can do without a flare the next morning, then build from there. Low-impact options such as cycling, swimming and strength work keep your fitness up while the heel settles.

It can reduce pain in the short term, but it does not change the load that caused the problem, and pain often returns without other treatment. Repeated injections into the heel also carry risks for the fat pad and the fascia. Injections are generally considered after loading, footwear and orthotic options have been tried, and are arranged through your GP or a specialist.