Buffalo Hump

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What is buffalo hump?

Buffalo hump refers to an unsightly lump of fat that develops at the top of the back between the shoulders. It can arise from a variety of conditions that are characterized by an increase in cortisol or glucocorticoid (hormones produced by the adrenal gland) levels in the bloodstream. The most common cause of elevated cortisol levels is the use of oral corticosteroid drugs, which are prescribed to treat different conditions, including inflammatory diseases.

Elevated cortisol levels can also occur when the body produces too much cortisol. The medical term for this condition is Cushing’s syndrome. Cushing’s disease is a specific form of Cushing’s syndrome in which a pituitary tumor produces elevated levels of a hormone that directs the adrenal glands to synthesize cortisol.

In some cases, buffalo hump may occur with osteoporosis, which is characterized by thinning and weakening of the bones.

Buffalo hump on its own does not cause serious side effects, but it may result from a serious disorder such as a tumor of the pituitary or adrenal glands. Treatment for buffalo hump may not be necessary in itself unless the underlying reason for the buffalo hump is a disease that requires treatment. In this case, treatment is dependent on the cause and may include changes in diet or exercise, surgical treatment of underlying tumors, or hormonal therapy.

Buffalo hump may be a sign of a serious condition that causes your body to produce too much of the hormone cortisol. If you develop an unexplained hump behind your shoulders, seek prompt medical care.

If your buffalo hump is persistent or causes you concern, seek prompt medical care.

What other symptoms might occur with buffalo hump?

Buffalo hump may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Endocrine symptoms that may occur along with buffalo hump

Buffalo hump may be accompanied by other symptoms indicative of excess cortisol including:

Other symptoms that may occur along with buffalo hump

Buffalo hump may accompany symptoms related to osteoporosis, including kyphoscoliosis or scoliosis (curvature of the spine).

Symptoms that might indicate a serious condition

In some cases, buffalo hump may occur with other symptoms that might indicate a serious condition which should be immediately evaluated. Seek immediate medical care if you, or someone you are with, have buffalo hump along with other serious symptoms including:

What causes buffalo hump?

Buffalo hump may arise for a variety of reasons, but it commonly occurs as a result of hormone imbalance or excessive fat accumulation. Hormone imbalance can result from high dosages of certain medications, such as steroids, or from endocrine disorders, such as Cushing’s syndrome. Cushing’s syndrome can be caused by abnormal processes inside the body, such as when the adrenal glands produce too much corticosteroid hormones due to an adrenal tumor. This occurs more commonly in children. A pituitary tumor in the brain can also be an underlying cause of Cushing’s syndrome and this occurs more commonly in adults. Buffalo hump may also be caused by obesity and may worsen because of underlying osteoporosis, a condition in which the bones thin and become weaker.

Medicinal side effect causes of buffalo hump

Buffalo hump may be caused by a variety of medications including:

  • Certain acquired immunodeficiency syndrome (AIDS) medications (lipodystrophy)
  • Cortisone
  • Hydrocortisone
  • Prednisone

Endocrine causes of buffalo hump

Buffalo hump can also be caused by endocrine (glandular) problems including:

  • Adrenal hyperplasia (excess growth of the adrenal glands)
  • Adrenal tumors
  • Cushing’s syndrome (disorder in which the body produces too much of the hormone cortisol)
  • Pituitary dysfunction or tumor

Other causes of buffalo hump

Buffalo hump can also occur due to other causes, such as obesity.

Serious or life-threatening causes of buffalo hump

In some cases, buffalo hump may be a symptom of a serious or life-threatening condition that should be immediately evaluated. These conditions include tumors of the adrenal glands or the pituitary gland.

Questions for diagnosing the cause of buffalo hump

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your buffalo hump including:

  • Do you have any other symptoms?
  • How old are you?
  • Do you have osteoporosis (thinning and weakening of the bones)?
  • Do you have any endocrine disorders?
  • What medications are you taking? How long have you been taking them?

What are the potential complications of buffalo hump?

Buffalo hump itself does not cause any serious complications, but it may lead to embarrassment or dissatisfaction with your personal appearance. Changes in diet and exercise may help you to manage buffalo hump. If your health care professional determines that a medication may be causing your buffalo hump, your treatment regimen may be changed. Because buffalo hump can be a sign of serious disease, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 13
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Hump behind the shoulders. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003112.htm
  2. Cushing syndrome. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/cushingssyndrome.html
  3. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013