Originally written by Dr Bill Leung (B.ChiroSc, M.Chiro, B Physio). Updated October 2026.
Quick answer: A neck hump is a rounded bump where the neck meets the upper back. It can be a curved upper spine (kyphosis, often called a dowager’s hump), a forward head and rounded shoulders from posture, or a pad of fat (often called a buffalo hump). Whether it can be reduced depends on the cause: rounding from posture can often be improved with better habits and exercise, a curve from wedged or fractured bones changes little, and a fatty hump needs its cause treated.
What is a neck hump?
“Neck hump” is used for three different things, which are easy to confuse:
- Postural rounding: the head sits forward and the shoulders round, often after years of desk and phone work. This is the most common cause in younger people.
- Kyphosis (dowager’s hump): the upper spine curves forward more than usual. It is common in older adults, particularly women, and is often caused by osteoporosis, where weakened spinal bones compress or fracture, sometimes with no obvious injury. In teenagers, a firm curve can come from Scheuermann’s disease. Arthritis can also cause it.
- A fatty hump (buffalo hump): a pad of fat at the base of the neck. It is often linked to too much of the hormone cortisol (Cushing syndrome), including from long term steroid medicines. Some HIV medicines and obesity can also cause it.
Symptoms
A mild hump may cause no symptoms at all, or just stiffness and aching in the neck and upper back. Some people feel self conscious about how it looks. A severe curve can cause very bad back pain and difficulty breathing, and rarely a large fatty hump presses on nerves. Numbness, tingling or weakness needs a doctor.
Can a neck hump be reversed?
It depends on the cause.
- Postural rounding can often be improved with better habits and exercise, which help you sit and stand taller and ease stiffness.
- A curve from fractured or wedge shaped bones changes very little, although exercise can still help ease pain and stiffness. Exercise makes only a small difference to the curve in older adults: in one trial of adults aged 60 and over with a rounded upper back, most of whom had no fractures, six months of back strengthening and posture training reduced the curve by about 3 degrees more than in people who didn’t train.
- A fatty hump won’t change with posture exercises. Its cause needs to be found and treated by a doctor.
What helps
Exercises
- Chin tucks: sit or stand tall and draw your chin straight back, keeping your eyes level. Hold for a few seconds and repeat 10 times.
- Shoulder blade squeezes: squeeze your shoulder blades back and down, hold for a few seconds and repeat 10 times.
- Doorway chest stretch: place your forearms on either side of a doorway and step forward until you feel a gentle stretch across your chest. Hold for 20 to 30 seconds.
- Upper back extension: lie face down and gently lift your chest a little off the floor, keeping your neck long and your eyes looking down. Hold for a few seconds and repeat. Skip this one if you are pregnant.
- Upper back strengthening: exercises such as rows with a resistance band.
If you have osteoporosis, avoid exercises that bend you forward or twist your spine, such as toe touches and sit ups, and get advice before starting.
Hands on treatment
A physiotherapist or chiropractor may add hands on treatment to ease pain and stiffness alongside exercise. Spinal manipulation isn’t suitable for everyone. It may not be safe if you take blood thinning medicine or have a higher risk of bleeding or stroke, have very weak or damaged bones or joints (such as severe osteoporosis), or have a nerve problem such as numbness, tingling or weakness in an arm or leg. Tell your practitioner about any of these before treatment.
Bone health
If osteoporosis is the cause, your doctor may suggest medicine to strengthen your bones and lower the risk of further fractures. Getting enough calcium and vitamin D and staying active also help look after your bones.
Do posture correctors work?
There is no strong evidence that posture products correct posture or prevent pain. Braces are mainly used for growing children with Scheuermann’s kyphosis, under a specialist.
When to see a doctor
See a doctor before starting exercises if:
- the hump is new or unexplained
- it comes with weight gain, a rounder face, purple stretch marks or easy bruising, especially if you take steroid medicines (don’t stop a prescribed steroid suddenly)
- you have sudden back pain, or have lost 4 cm (about 1.5 inches) or more in height, as this can mean a spinal fracture from osteoporosis, and many of these go undiagnosed
- you have numbness, tingling or weakness
- a child or teenager has a curve
- the curve is getting worse
If a curve makes it hard to breathe, see a doctor. Sudden or severe difficulty breathing is an emergency: call 999.
Frequently asked questions
Can a neck hump be reversed?
It depends on the cause. Rounding from posture can often be improved with better habits and exercise. A fixed curve from fractures or wedge shaped bones changes very little.
What exercises help a neck hump?
Good starting points are chin tucks (drawing your chin straight back), shoulder blade squeezes and a doorway chest stretch, plus strength work for the upper back. With osteoporosis, avoid toe touches and sit ups.
What causes a fatty hump at the back of the neck?
A fatty hump across the base of the neck is often linked to too much cortisol (Cushing syndrome), including from long term steroid medicines. Some HIV medicines and obesity can cause it too. A single soft lump under the skin may instead be a lipoma, a harmless fatty lump. See a doctor about any new lump, especially one that is painful, hard, doesn’t move or is getting bigger. Never stop a prescribed medicine without talking to your doctor.
Is a neck hump caused by looking at my phone?
Long hours looking down can add to a forward head and rounded shoulders, which can look like a hump. In older adults a hump is more often caused by changes in the spinal bones, so it is worth getting it checked.
Related reading: what causes poor posture.
Sources
- NHS: Kyphosis
- Mayo Clinic: Kyphosis
- Cleveland Clinic: Buffalo hump
- NHS: Cushing’s syndrome
- Mayo Clinic: Exercising with osteoporosis
- Katzman et al. 2017: exercise for hyperkyphosis in older adults (SHEAF trial)
- NHS: Herbal medicines and complementary therapies (chiropractic and osteopathy)
- NOGG 2024: summary of the main recommendations for osteoporosis
- Royal Osteoporosis Society: guidance on spinal fractures (2017)
- NHS: Lipoma
- Slater et al. 2019, JOSPT: “Sit up straight”, time to re-evaluate
- NHS: Steroids
Need help with this? Our posture and neck pain physiotherapy team at Total Health by Hong Kong Sports Clinic can assess you and start treatment in your first session, in Central, Kai Tak or Tin Hau. Message us on WhatsApp to book.
