What are the causes of buffalo hump and how is it treated? Scientific facts explained. -

Over the years of my experience as a radiographer, I have seen patients with buffalo hump more noticed during chest and neck x-rays and I have always wondered what really causes it and if there are any treatment options.

You may be someone with a buffalo hump wondering about this, in this article I will rely on scientific research about the subject, so that we can educate ourselves.

If you come here regularly: all our articles are based on research in the largest international database of medical studies: PubMed.

Happy reading!😀! and feel free to ask questions in the comments or share your own experience.🙏

Last updated: September, 2026. Written by Juliet Semakula, a diagnostic radiographer.

▶️What is a buffalo hump?

A buffalo hump, medically known as dorsocervical fat pad hypertrophy, is a collection of excess body fat that forms a visible abnormal lump or bulge at the base of the back of the neck and between the shoulder blades (Liu 2025).

Image showing accumulation of adipose tissue in the region of the neck and trunk associated with lipodystrophy (buffalo hump) source Carrese 2019.

▶️What are the causes of buffalo hump?

A buffalo hump (dorsocervical fat pad hypertrophy) is a buildup of fat at the base of the back of the neck, most caused by high levels of the hormone cortisol

The causes of a buffalo hump are normally associated with:

🟣Cushing’s Syndrome is when the hormonal disorder occurs when your body has too much cortisol, often due to an overactive adrenal gland, or pituitary or adrenal tumours causing a build-up of fat at the base of the back of the neck.

🟣Corticosteroid Medications when used for a long-term with a high-dose steroid drugs (like prednisone, cortisone, or hydrocortisone used for inflammation, asthma, or autoimmune diseases) mimics excess cortisol is known to trigger fat redistribution.

🟣Certain antiretroviral therapy (ART) drugs can cause abnormal fat redistribution, leading to a neck hump.

🟣Being obese or excess body weight can cause overall fat accumulation which can create or worsen a dorsocervical fat pad.

🟣Inherited genetic traits can cause your body to store fat in specific patterns or cause familial partial lipodystrophy, an abnormal distribution of fat tissue

🟣Diseases such as rare made lung disorder can cause abnormal, fatty masses to form around the neck, shoulders and upper body.

Source: Carrese 2019

In most cases, there is no underlying pathology that explains this condition.

If you notice a new or growing hump behind your shoulders, consult a healthcare provider. They can run blood or imaging tests to check your hormone levels and rule out underlying medical conditions

▶️How do I get rid of a buffalo hump? Treatment options:

A buffalo hump is neither dangerous nor painful, so there is no specific treatment unless there are complaints.

Treatment for a buffalo hump (dorsocervical fat pad) depends entirely on its underlying cause, which can range from poor posture to metabolic conditions or medication side effects.

I have seen some people finding it unpleasant or a source of discomfort, especially when it comes to moving their neck freely in different planes of motion.

It normally recommended to address the root medical cause as always, the primary step, followed by cosmetic or physical therapies if the hump persists

Here are some of the proposed treatments that are normally applied:

🟠Medication Adjustments can be made if the hump is caused by long-term use of corticosteroids (like prednisone) or certain antiviral medications, a doctor may taper the dosage or switch you to an alternative drug. This is normally done by medical supervision; you can not do it on your own.

If tests show your body is producing too much cortisol causing a Cushing’s syndrome, then treatment may include:

🟠Surgery such as lipectomy where fat cells are removed, and the skin is tightened.

🟠Liposuction, performed in cosmetic surgery.

🟠Specialized medications.

🟠 Using radiofrequency.

🟠Physical therapy is said to help reverse the “hump” if it’s a structural curve caused by a forward-head posture and rounded shoulders. Try to sit up straight and avoid looking down at phones for long periods.

🟠Manual massage or with devices such as massage guns while this may temporarily redistribute the fat, it quickly returns to its initial position.

🟠Adjusting your lifestyle. If general weight gain is a contributing factor, a structured diet focusing on lean proteins, whole vegetables, and healthy fats can help reduce overall body fat.

▶️Research studies on the effectiveness of some surgery treatment options:

Dorsocervical fibro-lipodystrophy, commonly known as “buffalo hump” presents a challenging deformity.

Various surgical techniques have been reported, however a comprehensive evaluation of their safety, efficacy, and recurrence rates remains lacking

A systematic review and meta-analysis that aimed to evaluate outcomes of surgical interventions of using

🟠Suction-assisted lipectomy, in managing dorsocervical fibro-lipodystrophy.

Liposuction is used to help remove the excess fat which is normally extra hard compared to fat on other body parts. With the proper technique and tools, it is normally broken down before it is extracted.

Twenty-two studies encompassing 218 patients with buffalo hump were included in the study.

Findings after using liposuction

♦️10.6 % which is about 1 in 10 patients had the hump grow back

♦️15.3% which is about 1 in 7 patients needed a second surgery to fix it (revision).

In well-performed surgeries on the right patients, the risk of the hump growing back is incredibly low, only 1.4%. The need for a second surgery dropped to just 1.3%.

Source: Escandón 2026

Another research study that followed up 55 patients with buffalo hump who underwent a tumescent anaesthesia, sharp cannula release and multi-port liposuction cannula aspiration for debulking technique designed to reshape the dorsocervical contour.

Forty-five patients with buffalo hump underwent this treatment from March 2022 to May 2024. Outcomes were assessed independently using a 4-point scale at 8-month follow-up

Treatment achieved favourable outcomes:

♦️ 91.1% of cases (good)

♦️44.4%; excellent:

♦️ 46.7%), with mean scores of 2.4

♦️ 0.7. Transient numbness

♦️ (26.7%) resolved within 6 months

Source: Liu 2025

🟠Tumescent anaesthesia, sharp cannula release and multi-port liposuction cannula aspiration for debulking was particularly effective for fibrosis-rich dorsocervical humps, offering the advantages including minimal scars and rapid recovery

It was established as an innovative and effective treatment method for mild to moderate fibrofatty dorsocervical hump.

This success wasn’t just a fluke in one hospital; it happened almost everywhere which means the treatment could work well when performed successfully.

▶️Will a buffalo hump go away if I lose weight or exercise?

Whether weight loss eliminates the hump depends entirely on what caused the fat accumulation in the first place. A buffalo hump may decrease in size with weight loss, but it will not always go away completely.

If you lose weight and the hump persists, clinical interventions are often required for permanent removal.

Exercises will help you strengthen muscles or neck mobility but will not make the fat forming the buffalo hump disappear.

Exercises will help maintain neck flexibility which is essential in your everyday life for example

To help you turn your neck while driving and sleeping comfortably in any position you want.

Remember you are at risk of developing stiffness in the neck, incorporating neck exercises as a routine can have a small positive effect on your posture.

▶️Here are the 3 exercises that seem to me the most relevant and easy to implement.

1️⃣Chin Tucks (Strengthens Deep Neck Flexors)

➡️Sit up completely straight on a chair, bring your two joined arms above your head as high and far back as possible, looking as far up and back as you can.

➡️Without tilting your head down, pull your chin straight back as if trying to make a “double chin”. Hold for 5 seconds and release.

➡️Repeat 10 to 15 times daily to take the pressure off your upper thoracic spine

2️⃣Scapular Squeezes (Strengthens Upper Back)

➡️Lie face down on a mat with your arms resting at your sides, palms down.

➡️Keeping your neck completely neutral, activate your upper back to pinch your shoulder blades together and lift your hands and shoulders a few inches off the floor.

➡️Hold for 2 seconds, lower slowly, and perform 3 sets of 12 repetitions.

3️⃣Doorway Chest Stretch (Opens the Front Body)

➡️Stand in an open doorway. Raise your arms to a 90-degree angle like a goalpost, placing your elbows and palms flat against the door frame.

➡️Step one foot forward slowly until you feel a comfortable, deep stretch stretching across your chest.

➡️Hold for 20 to 30 seconds. Repeat 3 times daily.

▶️How long does it take to correct a buffalo hump?

The time it takes to correct a buffalo hump depends completely on the method used to treat it, ranging from days for surgery to months for lifestyle or posture changes.

For example, if you choose a cosmetic procedure, the physical hump is removed instantly, though your body needs time to heal from the swelling.

🟢The Procedure: Takes 1 to 3 hours under anaesthesia.

🟢Initial improvements are visible after 4 to 6 weeks as the bulk of the swelling goes down.

🟢 Initial Recovery: Most people return to desk work and light activities within 3 to 7 days.

🟢It can take 3 to 6 months for residual swelling to fully resolve and show the final flat profile

Expect several months to over a year of consistent daily effort for physically remodelling stretched muscles and stiff ligaments to feel better.

We have come to the end of this article and hope we have learnt something on the subject matter; any questions let’s meet in the comments section.