Health Essentials from Cleveland Clinic

The dowager’s hump can develop in both men and women, but it gets its nickname from the slightly rounded hunch you might see at the base of an elderly woman’s neck.

This condition, which doctors call kyphosis, results from chronic forward-leaning, a posture that is 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 the upper vertebrae and a mass of tissue at the lower part of the neck.

What causes a dowager’s hump?

Fredrick Wilson, DO, Director of Cleveland Clinic’s Solon Center for Spine Health, says “Bad posture is the most common cause of a dowager’s hump. You have an increased curve in the upper neck so you have to lift the head, so it protrudes forward.”

Other possible causes include:

• Osteoporosis. A compression fracture causes the increased forward curve. This makes you drop your head forward more than normal and then pull it back and up to see forward. It’s those two things that cause the bump in the upper back.
• Congenital problem. Less frequently, the spine doesn’t form properly before birth.
• Scheuermann’s kyphosis. This shows up in teenagers, when the spine develops into a wedge shape instead of a rectangle.

This problem usually shows up around middle age. “It generally takes a while to develop because it’s a long-term weakening of the thoracic extensor muscles,” Dr. Wilson says.

How do you prevent a dowager’s hump?

If you are always bent forward, that’s extra weight pulling on and straining the back.

“That forward curve is bad for disks and increases the risk of disk problems and neck fatigue. Our muscles aren’t made for that kind of curve. It can cause upper and lower back pain and even some difficulty with tightness in the legs,” he says.

Maintaining good posture is the best way to prevent this problem. Also, try to keep osteoporosis from progressing to prevent the spine from developing compression fractures, which increase the forward curve of the upper back.

Can you reverse or cure a dowager’s hump?

• Start by doing chin tucks of the neck where you pull the chin straight back. This is good for the discs in the neck and strengthens the neck muscles.
• Perform scapular squeezes, where you squeeze the shoulder blades together, to improve the upper back muscles.
• Do push-ups into the corner of a room or through a door frame where you move the shoulders past the hands.

“I typically send people to physical therapy to help them learn to do these exercises correctly,” Dr. Wilson says.

“Luckily, they don’t take a lot of time. And if you do them regularly, you are going to have less pain, more energy and you’ll feel all around better.”

Dr. Wilson cautions that a dowager’s hump won’t go away overnight. It can take a long time to correct itself — months even. And, if you wait too long, it’s almost impossible to make it disappear completely.

If you think you might have a dowager’s hump, talk to your doctor about your therapy and treatment options.