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    Hump on upper back (dorsocervical fat pad)

    Buffalo hump; Dorsocervical fat pad

    A hump on the upper back between the shoulder blades is an area of fat accumulation on the back of the neck. The medical name of this condition is dorsocervical fat pad.

    Considerations

    A hump between the shoulder blades by itself is not a sign of a specific condition. Your health care provider must consider this along with other symptoms and test results.

    Causes

    Causes of dorsocervical fat pad include any of the following:

    • Certain medicines used to treat HIV/AIDS
    • Long-term use of certain glucocorticoid medicines, including prednisone, dexamethasone, and hydrocortisone
    • Obesity (usually causes more generalized fat deposition)
    • High level of the hormone cortisol (caused by Cushing syndrome)
    • Certain genetic disorders that cause unusual fat accumulation
    • Madelung disease (multiple symmetrical lipomatosis) often associated with excess alcohol intake

    Osteoporosis may cause a curvature of the spine in the neck called kyphoscoliosis. This causes an abnormal shape but does not by itself cause excessive fat in the back of the neck.

    Home Care

    If the hump is caused by a certain medicine, your provider may tell you to stop taking the medicine or change the dosage. Do not stop taking the medicine without first talking to your provider.

    Diet and exercise can help you lose weight and may relieve some fat accumulation due to obesity.

    When to Contact a Medical Professional

    Contact your provider if you have an unexplained hump behind the shoulders.

    What to Expect at Your Office Visit

    Your provider will perform a physical exam and ask about your medical history and symptoms. Tests may be ordered to determine the cause.

    Treatment will be aimed at the problem that caused the fat to develop in the first place.

    Open References

    References

    Angelidi AM, Tsoukis MA, Mantzoros CS. Lipodystrophy syndromes. In: Robertson RP, Giudice LC, Grossman AB, et al, eds. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 24.

    Tan SH, Tey HL, Lim JHL. Lipodystrophies. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 101.

            Review Date: 4/24/2025

            Reviewed By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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