April 10, 2023

Dowager’s Hump: What It Is and How To Get Rid of It

The hump at the base of your neck may be caused by osteoporosis or poor posture

Older person postioned sideways showing dowager hump.

Dowager’s hump, neck hump, text hump, hunchback or round back. The excessive curve of your spine goes by many names.

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It can develop in any sex, but it gets its nickname “dowager’s hump” from the slightly rounded hunch you might see at the base of an elderly woman’s neck.

This condition, which is medically called kyphosis, results from a chronic, forward-leaning posture that’s too common in our world of computer screens and other devices. Over time, a habit of poor posture can cause you to develop an abnormal curve of your upper vertebrae.

Wellness and preventive medicine specialist Candice Price, DC, explains what can cause a dowager’s hump and how to prevent it.

What is a dowager’s hump?

Considered a spinal condition, kyphosis is when your spine curves excessively forward. Your spine has natural curves to it, which helps you stand straight and supports your posture, but kyphosis can affect your posture and make standing a challenge.

In addition to having a hump in your upper back, you may also experience:

  • Rounded shoulders.
  • Tight hamstrings.
  • Pain or stiffness in your back and shoulder blades.
  • Extreme fatigue.
  • Headaches or migraines

According to Dr. Price, hyperkyphosis, when the curve of your spine is extreme, is associated with impaired lung function, reduced functional capacity and increased mortality.

So, how do you know if you have a dowager’s hump? Take a look at your profile in the mirror. Your back may appear as a rounded hunch (hence, why someone people refer to it as being hunchbacked) and your head juts forward.

Oftentimes, a dowager’s hump is mistaken for a buffalo hump, a condition that has a similar appearance. A buffalo hump is typically a symptom of Cushing’s disease. If you have Cushing’s disease you produce excess cortisol, which can lead to increased fat production.

“This excess fat often deposits behind the neck forming what is often referred to as the buffalo hump,” explains Dr. Price. “Both conditions can occur together or independently.”

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What causes it

“Bad posture is the most common cause of a dowager’s hump,” states Dr. Price. “Weak muscles of the upper back and neck, as well as tight muscles in the neck and chest are often the cause for this forward-leaning humped posture.”

Other possible causes include:

  • Osteoporosis. A compression fracture causes an increased forward curve. This causes your upper back to curve more, which forces you to lift your neck into more extension to be able to see forward. It’s those two factors that cause the bump in the upper back. Women and those assigned female at birth (AFAB) are more likely to develop a Dowager’s hump, as hormone changes during menopause can increase their risk of osteoporosis.
  • Degenerative changes in your spine. This is a slow, progressive loss of the normal structure and function of your spine. Degenerative changes range from mild to severe and most often occur as a result of the normal aging process. Arthritis, tumors and infections can also cause these changes.
  • Underlying bony or ligamentous pathologies. Spinal infections, fractures, tumors, calcifications of spinal ligaments and other bony or ligamentous pathologies can also change the shape of your spine.
  • Congenital problem. Less frequently, the spine doesn’t form properly before birth.
  • Scheuermann’s kyphosis. This shows up in teenagers, when their spine develops into a wedge shape instead of a rectangle.

A dowager’s hump usually shows up around middle age

How to get rid of a dowager’s hump

Are there dowager’s hump exercises you can do?

Dr. Price says depending on your age and the severity, you often can improve or reverse a dowager’s hump. You can accomplish this by strengthening your upper back and neck muscles. Increasing muscle tone helps pull up your shoulders and head.

She suggests doing the following exercises:

  • Chin tucks. To do a chin tuck, pull your chin straight back. This is good for the disks in your neck and strengthens your neck muscles. Do three sets of 10 daily.
  • Scapular squeezes. For these, squeeze your shoulder blades together, which helps improve your upper back muscles. Do three sets of 10 daily.
  • Doorway pectoral stretches. Stand in an open doorway, raising your arms like a goalpost with your palms forward. Place your palms on the door frame and step forward with one foot to feel the stretch across your chest. Hold for 20 to 30 seconds. Do two to three times daily.

Your healthcare provider may recommend physical therapy, which can help you learn how to do these exercises correctly.

“Luckily, these exercises don’t take a lot of time,” notes Dr. Price. “And if you do them regularly, you’re going to have less pain, more energy and you’ll free better all around. But the biggest benefit is a more upright posture, which helps reduce or get rid of the hump.”

She cautions that a dowager’s hump won’t go away overnight, though. It can take a long time to correct itself — months even.

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How to prevent a dowager’s hump

If you’re always bent forward, that’s extra weight pulling on and straining your back and neck.

“That forward curve increases the risk of disk problems and neck fatigue due to the increased pressure on the discs and increased load on the muscles. This happens because the neck has to work against gravity to hold the head up instead of balancing with it,” explains Dr. Price. “Our bodies aren’t made for that kind of curve. It can cause neck, upper back and lower back pain and even reduced lung capacity.”

Maintaining good posture is the best way to prevent the issue. You should also try to keep osteoporosis from progressing to prevent your spine from developing compression fractures, which increase the forward curve of the upper back.

Also, be sure to consider how you use your cell phone. It’s recommended that you hold your cell phone at eye level so you’re not bending your neck to see the screen. Do the same when it comes to your computer. Make any necessary height adjustments by using a computer stand or riser. You want to set up your workspace so your field of vision falls in the middle of your screen.

Taking breaks from your computer and cellphone can also help prevent a dowager’s hump. Also, take time during the day to think about your posture by pulling your spine straight and noting how that feels.

If you’re experiencing Dowager’s hump symptoms, a healthcare provider can recommend therapy and treatment options.

“The first step of treating a neck hump is determining the cause of the neck hump,” advises Dr. Price. “Talk to your primary care provider to rule out any underlying issues. For posture-related neck humps, it’s recommended that you improve your joint mobility, increase your muscle strength and practice good posture. Chiropractors and/or physical therapists can help you address posture-related neck humps.”

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