A hump on the back of the neck, also known as a neck hump or dowagers hump, can have various causes. Here are some of the most common causes:

• Poor posture: This is the most common cause of a neck hump. Weak muscles of the upper back and neck, as well as tight muscles in the neck and chest, are often the cause for this forward-leaning humped posture.

• Osteoporosis: A compression fracture causes an increased forward curve, which forces you to lift your neck into more extension to be able to see forward. It’s those two factors that cause the bump in the upper back. Women and those assigned female at birth (AFAB) are more likely to develop a Dowager’s hump, as hormone changes during menopause can increase their risk of osteoporosis.

• Cushings syndrome: A buffalo hump is most commonly a result of Cushing syndrome, a disorder of excess cortisol, a naturally occurring hormone that is involved in a variety of bodily processes, such as metabolism. High levels of the hormone cortisol can lead to increased fat synthesis. With Cushing syndrome, the fat produced often deposits in the neck, known as lipodystrophy. This produces the characteristic buffalo hump.

• Other medical conditions: A hump on the back of the neck can also be caused by other medical conditions, such as compression fractures, disc degeneration, and tumors.

To determine the cause of a neck hump, it is recommended to talk to a primary care provider to rule out any underlying issues. Treatment options depend on the underlying cause of the neck hump. For posture-related neck humps, it’s recommended to improve joint mobility, increase muscle strength, and practice good posture. Physical therapy and chiropractic care can also be helpful. For other causes, treatment options may include medication, surgery, or lifestyle changes.