Progression of Spinal Fusion: Over time, untreated AS can lead to the gradual fusion of the vertebrae in the spine. This fusion process, known as ankylosis, typically begins in the sacroiliac joints and can progress up the spine. As the joints fuse, the spine loses its flexibility, resulting in a rigid and stooped posture.

Decreased Range of Motion: The fusion of spinal joints not only affects posture but also leads to a substantial decrease in the range of motion. This limitation in movement can impact daily activities such as bending, twisting, and turning, making it challenging for individuals to perform routine tasks.

Chronic Pain and Discomfort: Persistent inflammation and structural changes in the spine contribute to chronic pain and discomfort. Individuals with long-standing untreated AS may experience constant pain, particularly in the lower back and buttocks. This pain can also radiate to other areas of the body, affecting the shoulders, hips, and neck.

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Impaired Respiratory Function: Severe cases of AS can lead to the involvement of the thoracic spine, potentially impacting respiratory function. As the chest wall becomes rigid due to spinal fusion, lung expansion may be limited, leading to breathing difficulties. This can result in reduced lung capacity and an increased risk of respiratory complications.

Joint Involvement Beyond the Spine: While AS primarily affects the spine, it can also involve other joints, such as the hips, shoulders, and knees. Untreated disease may lead to chronic inflammation and damage in these peripheral joints, contributing to additional functional impairment.

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Systemic Complications: Ankylosing spondylitis is not limited to the musculoskeletal system. In some cases, untreated AS can lead to systemic complications, including inflammation of the eyes (uveitis), heart problems, and, rarely, kidney issues. Regular monitoring and management are crucial to address these potential complications.

Psychosocial Impact: Living with untreated AS for several decades can have a profound impact on an individual's mental and emotional well-being. Chronic pain, physical limitations, and changes in appearance may contribute to feelings of isolation, depression, and anxiety.