Posture guide
A "neck hump" can mean different things: a soft pad of fat over the base of the neck (often called a buffalo hump), a more rounded upper back (sometimes called a dowager's hump), the normal bony bump of a vertebra that everyone has, or a fatty lump called a lipoma. They have different causes and need different things.
Exercise can't melt a fat pad, and chin tucks won't remove one. A fat pad can go with overweight, and sometimes with steroid medicines or Cushing's syndrome, which need a GP. A rounded upper back responds a little to back-strengthening. This guide explains the differences, what exercise can and can't change, and when to get checked.
A neck hump can be a soft fat pad over the base of the neck, a rounded upper back, the normal bony bump of a vertebra, or a lipoma (a soft, harmless fatty lump). A GP can usually tell which it is, and can arrange a scan if there's doubt.
A fatty hump can go with overweight and metabolic problems, and with Cushing's syndrome, which is most often caused by taking high-dose steroid medicine for a long time. Older HIV medicines also caused fatty humps.
Most trials found exercising one area didn't remove fat from it; one small trial found a little. We found no study that tested exercise for a neck fat pad, and chin tucks don't melt it.
If the hump is a rounded upper back, back-strengthening reduced the curve by about 3 degrees in a 6-month trial, and a review of 24 studies found a small benefit. The kyphosis guide covers it.
See a GP for a lump that's growing, hard, painful, red or hot; for a hump with a round red face, thin arms and legs, easy bruising or stretch marks, especially if you take steroids; or for a newly rounded back with pain or height loss. Never stop steroid medicine on your own.
A fatty hump can be removed by liposuction or surgery; in low-quality studies it came back after liposuction in about 1 in 10. The NHS usually removes a lipoma only if it's growing or causing problems.
A soft pad of fat over the base of the neck and the top of the back, called a dorsocervical fat pad. In 383 people who had surgery for a buffalo hump, about 78% had a fat pad, 11% a more general build-up of fat and 10% a lipoma; only one had HIV.
Source 1
"Dowager's hump" is an old name for a rounded upper back in later life (age-related hyperkyphosis), which can come from disc wear, weaker back muscles or spinal fractures. The kyphosis guide covers it in detail.
Source 2
Everyone has a bony bump at the base of the neck: the back of a vertebra. Textbooks name the seventh neck vertebra (C7) as the most prominent, but in 39 bodies studied after death it was C7 in about half, C6 in about a third and C5 in about 1 in 10.
Source 3
A lipoma is a soft, fatty lump that grows under the skin. Lipomas are common and harmless, are often found on the shoulders or back, and may move slightly when you press them.
Source 4
In a small series of 12 people with a buffalo hump who didn't have HIV, the average body mass index was 30 (the threshold for obesity), and most had high blood pressure, diabetes or high cholesterol; three were newly diagnosed. The authors suggested checking for these conditions. The series is tiny, so treat it as a reason to ask, not as proof.
Cushing's syndrome is caused by too much of the hormone cortisol, most often from taking high doses of steroid medicine, such as prednisolone, for a long time, and less often from a growth in the pituitary or adrenal gland.
It adds fat to the neck, upper back, chest and tummy, with thin arms and legs, a red, round face, easy bruising, stretch marks and weak muscles at the tops of the arms and legs. The NHS advises seeing a GP, particularly if you take steroid medicine, and not stopping steroids without talking to your doctor.
Older HIV medicines, especially stavudine and zidovudine, caused fat loss in some areas and fat gain in others, including fatty lumps. Switching to newer drugs reduced it, but it doesn't always go away. Modern HIV treatment is linked more to general weight gain.
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In 24 adults, 6 weeks of abdominal exercise didn't reduce tummy fat. In 11 people, 12 weeks of training one leg reduced fat elsewhere in the body but not in that leg. One small trial in 16 men found trunk fat fell more when tummy exercises were added to running. We found no study that tested exercise for a neck fat pad.
In the SHEAF trial (Study of Hyperkyphosis, Exercise and Function), 6 months of back-strengthening and posture classes reduced the upper-back curve by 3 degrees on X-ray, and a review of 24 studies found a small benefit. Spinal bones that have fractured keep their compressed shape.
Exercise programmes for forward head posture moved the head back by about 3 degrees in trials, and lying chin tucks improved how people hold their head. That changes head position, not the fat over the neck.
See a GP to check for Cushing's syndrome, especially if you take steroids; if steroids are the cause, treatment may include reducing them gradually under medical supervision. If you take HIV treatment, ask your HIV clinic about your medicines. If you're overweight, ask whether a check of your blood pressure, blood sugar and cholesterol makes sense.
Because exercise doesn't target one spot, losing fat overall, through diet and activity, is the logical route for a fat pad. We found no study that measured the neck pad after weight loss, so this is our editorial reasoning. The exercise for weight loss guide covers what works.
Back-muscle exercises, such as the low cobra and the seated upper-back lift, at the UK osteoporosis consensus dose of 3 to 5 repetitions held 3 to 5 seconds, at least twice a week, building towards the SHEAF trial's 2 sets of 8 if you don't have osteoporosis. The kyphosis guide has the full routine.
Lying chin tucks, up to 10 holds of up to 10 seconds once or twice a day at a light effort (our editorial starting point), with upper-back strength work. These change head position a little, not fat. The forward head posture guide has the details.
These change posture a little; none removes fat. Chin tucks, 10 holds of 5 seconds, and lying chin tucks, up to 10 holds of 10 seconds (our editorial starting points); seated upper-back lifts and low cobras, 3 to 5 holds of 3 to 5 seconds, at least twice a week (UK osteoporosis consensus); Y-T-W raises, 5 to 8 of each letter, and wall angels, 8 slow slides (our editorial starting points).
3D demoChin tuckBeginner · No equipment
3D demoLying chin tuckBeginner · No equipment
3D demoProne Y-T-W raisesBeginner · No equipment
3D demoWall angelBeginner · A wall
3D demoSeated upper-back lift (sit tall, shoulders back)Beginner · A bench or box
3D demoLow cobra (Bhujangasana)Beginner · No equipmentA fatty hump can be removed by liposuction or by cutting it out. In a review of 22 low-quality studies (218 patients, mostly with HIV), the hump came back in about 1 in 10 after liposuction, and fluid collections, bleeding under the skin and wound problems were more common after cutting it out.
In 383 people treated at one clinic, none came back, but 14% had numbness and 6% a fluid collection.
Because lipomas are harmless, the NHS usually removes one only if it's growing or causing problems.
Source 4
See a GP about any new lump, and sooner if it's:
Source 4
See a GP if a hump comes with a red, round face, thin arms and legs, easy bruising, stretch marks or weak muscles at the tops of your arms and legs, especially if you take steroid medicine. Don't stop or cut down steroids on your own: talk to your doctor first.
A new or increasing hunch with back pain or height loss can be a spinal fracture from osteoporosis, and not every spinal fracture hurts. See a GP.
They move the head back a few degrees; they don't remove a fat pad, and we found no study testing exercise for one.
It can be a fat pad, a lipoma, a rounded upper back or the normal bump of a vertebra.
We found no study linking phone use to a neck hump. Fat pads go with weight, metabolic problems, steroid medicine and older HIV medicines, and a rounded upper back mostly comes with age.
It's one cause, and it comes with other signs. Fat pads can also go with overweight and metabolic problems, and older HIV medicines caused them.
Braces change your position while you wear them, and we found no study showing a lasting change. They can't remove fat.
It can be a pad of fat over the base of the neck, a more rounded upper back, or the bony bump of a vertebra that everyone has. Less often it's a fatty lump called a lipoma. A fat pad can go with overweight, with long-term steroid medicine through Cushing's syndrome, and with older HIV medicines.
It can be either. A fatty lump usually feels soft and may move slightly under the skin, while the bony bump is part of your spine; the most prominent one can be the sixth or seventh neck vertebra. If you're not sure, a GP can examine it.
"Dowager's hump" is an old name for a rounded upper back in later life, sometimes from spinal fractures. "Buffalo hump" is a fat pad at the base of the neck, seen in Cushing's syndrome, with older HIV medicines and with overweight.
Not if it's fat. In most trials, exercising one area didn't remove fat from that area, and we found no study that tested exercise for a neck fat pad. If the hump is a rounded upper back, back-strengthening reduced the curve a little in trials.
We found no trial showing that. Chin tucks train the deep neck muscles and can move the head back a few degrees, but they don't burn the fat over the neck.
It can go with metabolic problems: in a small series of 12 people with a buffalo hump who didn't have HIV, most had high blood pressure, diabetes or high cholesterol, and the authors suggested checking for them. If you have a fatty hump, ask your GP whether a health check makes sense.
Yes. Taking high-dose steroid medicine for a long time is the commonest cause of Cushing's syndrome, which adds fat to the neck and upper back. Don't stop or cut down steroids yourself; talk to your doctor.
See a GP about any new lump, and sooner if it's growing, hard, painful, red or hot. Go too if you also have a round red face, thin arms and legs, easy bruising or stretch marks, especially if you take steroids. A newly rounded upper back with back pain or height loss also needs checking, as it can be a spinal fracture.
A fatty hump can be removed by liposuction or surgery; in low-quality studies it came back after liposuction in about 1 in 10. On the NHS, a lipoma is usually only removed if it's growing or causing problems.
It depends on the cause. Treating Cushing's syndrome is the route for a steroid-related hump, and losing fat overall is the logical route for a fat pad, though we found no study measuring it. Fractured spinal bones keep their shape, and a posture-related curve changes a little with exercise.
Braces change your position while you wear them, and we found no study showing a lasting change. They can't remove a fat pad.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Get a curve or hunch that is new or getting worse checked, above all in a growing child or after a fall, and get urgent help for numbness or weakness in the legs or a change in bladder or bowel control. Health disclaimer.