What Causes a Buffalo Hump on the Back of the Neck?

A buffalo neck hump, or dorsocervical fat pad, can develop when fat collects on the back of your beck. Learn about causes, symptoms, and treatment

A buffalo neck hump, also called a dorsocervical fat pad, is a hump-like swelling on the upper back between the shoulder blades. It occurs due to excessive fat accumulation on the back of the neck. Causes may include:

1. Certain medications such as corticosteroids (prednisone, hydrocortisone, cortisone) and some medications used to treat HIV/AIDS (particularly older medications)
2. Obesity (a buffalo neck hump may be seen along with generalized fat deposition)
3. Cushing’s syndrome (a condition in which there is excess cortisol production in the body)
4. Genetic predisposition
5. Madelung’s disease (a condition in which there is an unusual fat buildup around the neck, shoulders, upper arms, trunk, thighs, and hips)
6. Certain tumors, such as tumors of the pituitary gland or cortisol-producing tumors

Generally, a buffalo neck hump is itself a harmless condition. In some cases, however, it may be a sign of an underlying serious condition such as a tumor of the adrenal or pituitary gland. It’s therefore important to seek medical attention to rule out other conditions. 

If you believe the buffalo neck hump developed after you started taking certain medications, talk to your doctor before stopping your medications.

Buffalo neck humps generally are not associated with any other symptoms. Most people seek medical attention because of cosmetic concerns. However, in some cases, symptoms may be related to underlying conditions such as high cortisol levels. Symptoms may include:

• Round or moon-shaped face
• Facial redness or flushing
• Abdominal striae or stretch marks
• Hirsutism (excess hair growth on the face and other parts of the body)
• Acne
• Easy bruising
• Thin skin
• Excessive thirst
• Irregular menstrual cycles
• Mood changes
• Weakness
• Decreased libido
• Frequent urination

Other problems that may accompany a buffalo neck hump include high blood pressure, increased blood sugar levels, and weak bones (osteoporosis), which can cause an increased risk of fractures and abnormal curvature of the spine (scoliosis or kyphoscoliosis). Such symptoms shouldn’t be ignored and may require urgent medical attention.

Treatment of a buffalo neck hump may not be necessary unless the underlying reason for the hump is a disease that requires treatment. In such cases, treatment is dependent on the cause and may include changes in diet or exercise, surgical treatment of underlying tumors, or hormonal therapy.

• If medications are responsible for the hump, your doctor may give you another medication or change the dose. Do not stop medications or adjust doses yourself without consulting your doctor.
• Cushing’s syndrome may require prescription medications or surgery.
• Pituitary or adrenal tumors may require chemotherapy, radiation therapy, or surgery.
• Your doctor may advise weight reduction through physical activity and dietary changes.
• Your doctor may recommend cosmetic surgery to remove the abnormal fat deposition.

Lifestyle modifications can play a huge role in correcting a buffalo neck hump and getting rid of the lump on the back of your neck. 

Healthy diet

Because a buffalo neck hump is usually caused by excessive fat deposition on the back of the neck, losing weight may help in treatment. Your doctor or dietician may help you select a diet plan that helps you reduce calorie intake for safe and effective weight loss. Choose sustainable and healthy dietary habits such as including plenty of vegetables, fruits, whole grains, and lean meat in your diet. Concentrate more on eating protein and fiber-rich food over sugary or fatty foods in order to stay full for longer. 

Sometimes a hump on the back of the neck is caused by osteoporosis (thinning of the bone), in which case the condition is called Dowager’s hump. Your doctor may prescribe medications to improve bone health and recommend eating foods rich in calcium and vitamin D such as fish, mushrooms, eggs, and dairy.

Exercise

Reducing overall body fat while gaining muscle mass helps you attain a healthy and easy-to-maintain weight while reducing the hump on the back of your neck. It also helps improve your posture. For losing weight and gaining muscle mass, try a combination of cardio and weight-training workouts. 

Weight-bearing exercises help you gain muscles while lowering your body fat percentage. Include stretching and relaxation workouts such as yoga as they will also help lower the stress hormones (cortisol) in your body. 

Stretching and postural correction, as well as physical therapy under professional guidance, may help especially with Dowager’s hump. Below are a few stretches that help strengthen your upper back and neck muscles and help you get rid of the hump:

• Chin tucks: 
  • Sit or stand in a comfortable position. 
  • Tuck your chin backward and hold this position for 10 seconds. 
  • Come back to the neutral position and then repeat. 
  • Do 10 such stretches 3 times a day.
• Neck stretches: 
  • Sit or stand in a comfortable position. 
  • Tilt your head sideways as if you are trying to touch your shoulder with your ear. 
  • Use the hand on the same side to gently pull your head toward the side.
  • Hold for 20 seconds and relax. 
  • Do 5 such stretches on each side 3 times a day.
• Standing push-ups: 
  • Stand at an arm’s distance from a door frame so that your arms are at 90 degrees to the length of the frame. 
  • Keeping your feet fixed, lean toward the door as if doing a push-up. You may keep your arms at a greater height to increase the intensity of the stretch. 
  • Start with 10 such push-ups and increase with time. 
  • Do 2-3 sets a day.
• Shoulder-blade (scapular) squeeze: 
  • Sit comfortably in a chair. 
  • Shift your weight slightly forward so that you are not rounding your back. 
  • Raise your arms at the level of your shoulders so that the palms face forward and the elbows are bent. 
  • Squeeze your shoulder blades together as you move your arms back. 
  • Hold this position for 10 to 15 seconds. 
  • Relax and repeat 5-10 times 3 times a day.