Buffalo Hump: What Is It, and Why Does It Happen?

Medically Reviewed By Avi Varma, MD, MPH, AAHIVS, FAAFP

A buffalo hump is a lump of fat that develops between the shoulders at the top of the back. Some experts call it a dorsocervical fat pad. It can be due to a variety of conditions that are characterized by an increase in cortisol or glucocorticoid levels in the bloodstream. Elevated cortisol levels can also occur when the body produces too much of this substance. 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.

One cause of elevated cortisol levels is the use of oral corticosteroid drugs. These are prescribed to treat different conditions, including inflammatory diseases.

Read on to learn more about buffalo humps, including what they are, what causes them, and associated risks.

What is a buffalo hump?

A woman with short hair is bending her neck downward
Marija Strajnic/Stocksy United

Doctors might refer to a buffalo hump as a dorsocervical fat pad. This is a collection of fatty tissue on the back of the neck that appears as a hump between the shoulder blades.

Buffalo humps are not usually the only symptom that doctors can use to diagnose a certain condition. Instead, they will order more tests and consider other symptoms you may be experiencing when diagnosing the cause.

Vs. kyphosis

Another cause of a rounded back is kyphosis. According to the American Academy of Orthopaedic Surgeons (AAOS), kyphosis occurs when the back rounds to more than 50 degrees. A spine without kyphosis will round to no more than 45 degrees.

Kyphosis can result from an underlying condition such as a spinal irregularity, or it can happen after prolonged poor posture. If poor posture is the cause of kyphosis, the lump in the back will disappear once the person stands up straight.

Kyphosis may appear lower down than a dorsocervical fat pad, which usually sits between the shoulder blades or closer to the neck. The latter is also a fatty lump rather than a spinal bend.

Vs. osteoporosis

In some cases, a hump in the spine may occur with osteoporosis. This condition involves the thinning and weakening of the bones.

According to the AAOS, osteoporosis can cause the upper back to appear rounded. This is due to the formation of bone not keeping up with its removal. Osteoporosis is more common in older adults.

Doctors can diagnose osteoporosis using special X-rays and blood and urine tests.

What causes a buffalo hump?

Buffalo humps, or dorsocervical fat pads, may arise for various reasons. However, they commonly occur as a result of a hormone imbalance or excessive fat accumulation.

Hormone imbalances can result from high dosages of certain medications, such as steroids, or from endocrine disorders, such as Cushing’s syndrome.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, Cushing’s disease happens when the body makes too much of a hormone called cortisol.

Cushing’s syndrome can be due to atypical processes inside the body, such as when the adrenal glands produce too many corticosteroid hormones due to an adrenal tumor. A pituitary tumor in the brain can also be an underlying cause of Cushing’s syndrome, and this occurs more commonly in adults.

Medicinal side effect causes of a buffalo hump

Buffalo humps may happen due to a variety of medications, including:

Endocrine causes of a buffalo hump

A buffalo hump can also be an effect of endocrine problems, including:

  • adrenal hyperplasia, which refers to the excess growth of the adrenal glands
  • adrenal tumors
  • pituitary dysfunction or tumors

Other causes of a buffalo hump

Buffalo humps can also Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source occur due to other causes, including obesity and adipose metabolism disorders such as Madelung’s disease.

Serious or life threatening causes of a buffalo hump

In some cases, a buffalo hump may be a symptom of a serious or life threatening condition that needs immediate evaluation. These conditions include tumors of the adrenal glands or the pituitary gland.

Questions for diagnosing the cause of a buffalo hump

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

  • Do you have any other symptoms?
  • How old are you?
  • Do you have osteoporosis?
  • Do you have any endocrine disorders?
  • What medications are you taking? How long have you been taking them?

When should I contact a doctor for a buffalo hump?

A buffalo hump on its own does not cause serious side effects, but it may result from a serious condition such as a tumor of the pituitary gland or adrenal glands.

Treatment for a buffalo hump may not be necessary unless the underlying reason is a condition that requires treatment. In these cases, treatment depends on the cause and may include:

  • making changes to your diet or exercise habits
  • undergoing surgical treatment for any underlying tumors
  • trying hormonal therapy

A buffalo hump may be a symptom 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 a buffalo hump?

Buffalo humps may accompany other symptoms, which vary depending on the underlying condition. Doctors will need to know about other symptoms you may be experiencing in order to make a diagnosis.

Endocrine symptoms that may occur alongside a buffalo hump

Buffalo humps may occur alongside other symptoms that indicate excess cortisol, including:

Other symptoms that may occur alongside a buffalo hump

Buffalo humps may also accompany symptoms related to osteoporosis, including kyphoscoliosis or scoliosis, which are conditions that cause a curvature of the spine.

What are the complications of a buffalo hump?

A buffalo hump itself does not cause any serious complications, but it may lead to embarrassment or dissatisfaction with your appearance.

However, because a buffalo hump can indicate a serious condition, not seeking treatment can result in serious complications and permanent damage.

Once a doctor has diagnosed the underlying cause, it is important for you to follow the treatment plan that you and your healthcare professional design specifically for you. This can help reduce your risk of potential complications, including:

What treatment options are available for a buffalo hump?

Treatment options for a buffalo hump will depend on its underlying cause. If the cause is an endocrine disorder or a condition such as osteoporosis, a doctor will suggest treatments that can target these causes.

Treating a dorsocervical fat pad could involve:

  • Maintaining a moderate weight: Making some dietary and exercise-related changes could help reduce the appearance of the buffalo hump.
  • Changing your medication regimen: However, do not stop taking any medications until you have spoken with your doctor.
  • Undergoing liposuction: This surgical procedure can remove the fat that has accumulated by the neck.

Is it possible to prevent a buffalo hump?

It is not always possible to prevent a buffalo hump because it may be a symptom of an underlying condition. However, the following measures may help prevent people at risk of a buffalo hump from developing it:

  • maintaining a moderate weight
  • avoiding alcohol
  • maintaining good posture

If you experience any symptoms that could be related to an endocrine disorder, contact a doctor. If you are taking medications that could be causing a buffalo hump, such as corticosteroids or antiretroviral drugs, do not stop taking these until you have spoken with a doctor.

Other frequently asked questions

The following are some other commonly asked questions about buffalo humps.

How do you get rid of a buffalo hump naturally?

If a buffalo hump results from an underlying condition, you will need medical treatment to reduce its appearance. However, maintaining a moderate weight and ensuring good posture can also help reduce the appearance of a buffalo hump.

What is the difference between a dowager’s hump and a buffalo hump?

Some people may refer to a buffalo hump as a “dowager’s hump.” However, dowager’s humps are due to kyphosis, which involves bone placement and posture. Buffalo humps are due to Trusted Source American Journal of Clinical Nutrition Peer reviewed journal Go to source the development of a fat pad between the shoulder blades.

How long does it take to get rid of a buffalo hump?

The time it takes to get rid of a buffalo hump will depend on what is causing it. Steady, healthy weight loss — if needed — can help reduce the appearance of a buffalo hump. Treating the underlying cause — such as an endocrine disorder — may also be effective with certain medications, among other options.


A buffalo hump, or a dorsocervical fat pad, is a collection of fatty tissue at the top of the back, near the neck. It can appear as a hump between the shoulder blades.

Some people mistake the symptoms of kyphosis or osteoporosis for a dorsocervical fat pad. There are links between these conditions.

A buffalo hump alone is not enough for a doctor to diagnose a certain condition. They will ask about other symptoms you may be experiencing and order more tests accordingly.

Buffalo humps may result from excess cortisol in the body, possibly due to an endocrine disorder or the use of certain medications.

Was this helpful?

Medical Reviewer: Avi Varma, MD, MPH, AAHIVS, FAAFP
Last Review Date: 2022 Apr 28
View All Endocrinology and Metabolism Articles
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.