What is Buffalo Hump and how is it treated?

Buffalo Hump - an unpleasant name for an even more unpleasant condition. Buffalo or Dowager's Hump (or as it's referred to medically, a dorsocervical fat pad), is a condition where a prominent bump develops at the base of the neck, between the shoulder blades.

Causes

There are two primary causes for this condition:

1. Postural (Dowager's Hump): This is caused by chronic forward head posture and hyperkyphosis (excessive rounding of the upper back). Over time, the body lays down extra connective tissue and fat in this area to protect the spine from the abnormal mechanical stress.
2. Medical/Hormonal (Buffalo Hump): This is an accumulation of fat caused by high levels of cortisol in the body, often seen in Cushing's syndrome or as a side effect of long-term corticosteroid medication use.

Treatment

If the cause is hormonal, medical intervention is required to manage cortisol levels. However, if the hump is postural, physical therapy and manual therapy are highly effective:

• Postural Correction: Exercises to strengthen the deep neck flexors and the muscles between the shoulder blades (rhomboids and mid-trapezius).
• Manual Therapy: Remedial massage and chiropractic adjustments can help mobilize the stiff thoracic spine, release tight chest muscles, and break down the fibrotic tissue at the base of the neck.