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Hump behind the shoulders (Dorsocervical fat pad)

A hump behind the shoulders is an area of fat accumulation on the back of the neck. The medical name of this condition is dorsocervical fat pad.


A hump behind the shoulders by itself is not a sign of a specific condition. The health care provider must consider this along with other symptoms and test results.


Cause of dorsocervical fat pad includes any of the following:

  • Certain medicines used to treat HIV or AIDS
  • Long-term use of certain glucocorticoid medicines, including prednisone, cortisone, and hydrocortisone
  • Obesity
  • High level of the hormone cortisol (caused by Cushing syndrome)
  • Certain genetic disorders that cause unusual fat accumulation

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

Make an appointment with your provider if you have an unexplained hump behind the shoulders.

What to Expect at Your Office Visit

Your provider will perform a physical examination 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.

Alternative Names

Buffalo hump; Dorsocervical fat pad


Bolognia JL, Schaffer JV, Duncan KO, Ko CJ. Lypodystrophies. In: Bolognia JL, Schaffer JV, Duncan KO, Ko CJ, eds. Dermatology Essentials. Philadelphia, PA: Elsevier Saunders; 2014:chap 84.

Tsoukis MA, Mantzoros CS. Lypodystrophy syndromes. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 37.

Review Date 10/28/2015

Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.