A “neck hump,” often referred to as a “buffalo hump” or “Dowager’s hump,” presents as a visible accumulation of tissue at the base of the neck, specifically where the cervical and thoracic spine meet. While the terms are sometimes used interchangeably, a “buffalo hump” generally implies an excess fat deposit, whereas a “Dowager’s hump” typically refers to an excessive spinal curvature.
Behavioral and Ergonomic Contributors
Poor posture is a common behavioral factor leading to the development of a neck hump. Prolonged periods spent in a forward-leaning position, such as looking down at a phone or computer screen, can significantly strain the cervical spine. This habit, often termed “tech neck,” causes the head to jut forward, increasing the load on the neck muscles and spine. An adult head weighs approximately 10 to 12 pounds, and tilting it forward at even a 45 to 60-degree angle can increase the strain on the neck muscles to around 50 to 60 pounds.
The continuous forward head posture and rounded shoulders contribute to structural changes in the spine, specifically an excessive forward curvature known as kyphosis. The muscles in the upper back and neck can weaken, while chest muscles may become tight, further pulling the shoulders forward and exacerbating this curvature.
Ergonomic setups also play a significant role in preventing or contributing to a neck hump. Incorrect positioning of computer monitors, keyboards, and other devices forces individuals into unnatural postures. For instance, a computer screen set too low encourages looking downward, perpetuating the forward head posture. Similarly, holding a phone at chest or lap level instead of eye level encourages neck flexion.
Maintaining consistent poor posture can lead to the accumulation of tissue at the base of the neck, visually presenting as a hump. Regular breaks, adjusting screen heights, and being mindful of body alignment throughout the day are important steps to mitigate these effects.
Underlying Medical and Physiological Factors
Beyond behavioral habits, certain medical conditions and physiological processes can also lead to the formation of a neck hump. Cushing’s Syndrome is one such condition, characterized by prolonged exposure to high levels of cortisol, a hormone produced by the adrenal glands. Excess cortisol can result from the body producing too much of the hormone, often due to a tumor in the pituitary or adrenal glands, or from the long-term use of certain medications like glucocorticoids. This excess cortisol leads to a redistribution of fat throughout the body, commonly causing fat to accumulate specifically at the base of the neck, forming a “buffalo hump.”
Osteoporosis, a condition where bones become weak and brittle due to decreased bone density, is another significant medical cause. As bone mass diminishes, the vertebrae in the upper spine can weaken and become wedge-shaped, or even suffer compression fractures. This structural change in the spine can lead to an exaggerated forward curvature, known as kyphosis, which presents as a “Dowager’s hump.” The hump caused by osteoporosis is a result of skeletal deformity rather than fat accumulation.
Certain medications can also induce a neck hump as a side effect, primarily through their impact on fat distribution. Some antiretroviral drugs used to treat human immunodeficiency virus (HIV), particularly older protease inhibitors, can cause lipodystrophy. Lipodystrophy involves an abnormal redistribution of fat, leading to fat loss in some areas and accumulation in others, including the dorsocervical region, which appears as a buffalo hump.