A buffalo hump is a noticeable accumulation of fat at the base of the neck and the upper back, which doctors call a cervicodorsal fat pad. This rounded prominence develops between the shoulders. While the hump is a physical change, its appearance often indicates an underlying issue involving fat distribution, hormones, or metabolism, warranting a medical evaluation to identify the root cause.
Anatomical Description and Appearance
The buffalo hump is an abnormal deposition of adipose tissue concentrated at the junction of the neck and the upper back. This accumulation sits over the seventh cervical vertebra (C7), the most prominent bone at the base of the neck. The appearance is a distinct, rounded lump that can range from subtle fullness to a pronounced mound. This tissue change is a form of localized lipodystrophy, a problem with how the body stores fat. The fat within the hump can feel denser and firmer than generalized body fat. It is important to distinguish the buffalo hump from a “dowager’s hump,” which is a skeletal curvature of the upper spine (kyphosis) often caused by osteoporosis. The buffalo hump is specifically a change in tissue composition, not solely a change in bone alignment.
Underlying Medical and Lifestyle Causes
The development of a cervicodorsal fat pad is frequently a symptom of systemic problems affecting hormonal balance and fat distribution. The most significant medical cause is Cushing’s Syndrome, a condition where the body is exposed to high levels of cortisol over a prolonged period. This excess cortisol, whether produced internally by the adrenal glands or introduced externally, triggers a characteristic redistribution of fat to specific areas, including the neck.
Exogenous causes include the long-term use of corticosteroid medications like prednisone or hydrocortisone. These drugs mimic the effects of cortisol and can lead to fat pad formation. Certain antiretroviral medications used to manage HIV infection, particularly older protease inhibitors, also cause lipodystrophy and fat accumulation in this region.
Lifestyle and metabolic factors also play a role. General obesity and weight gain can lead to excess fat deposits, including in the upper back. When caused by obesity or metabolic syndrome, the hump is often less pronounced than in hormonal disorders. Rare conditions that impact fat metabolism, such as Madelung’s disease, can also result in unusual fat buildup around the neck and shoulders.
Medical Evaluation and Associated Health Risks
A medical evaluation is necessary to determine the precise cause of the buffalo hump, as it may signal a serious underlying health condition. Diagnosis begins with a thorough physical examination and a review of the patient’s medical history, including current medications. Doctors look for other symptoms accompanying conditions like Cushing’s Syndrome, such as easy bruising, muscle weakness, and a rounded facial appearance.
Blood tests are standard to measure hormone levels. If Cushing’s Syndrome is suspected, specialized tests assess cortisol levels, often involving timed collections. For metabolic issues, a lipid panel checks for high cholesterol and triglyceride levels, and blood glucose tests screen for diabetes or pre-diabetes.
The health risks are not from the fat pad itself, but from the systemic condition that caused it. Uncontrolled Cushing’s Syndrome significantly raises the risk of severe health problems, including hypertension, diabetes, and osteoporosis. A hump linked to metabolic syndrome increases the long-term risk of cardiovascular disease and stroke. Identifying and treating the underlying disorder is the primary goal.
Strategies for Reduction and Management
Management of a cervicodorsal fat pad must focus first on addressing the underlying medical condition. For Cushing’s Syndrome, primary treatment involves normalizing cortisol levels, often requiring surgery to remove a tumor on the adrenal or pituitary gland. When the hump is a side effect of prescribed medication, a physician will supervise the gradual tapering of the dosage or switch the patient to an alternative treatment.
Lifestyle modifications are the primary intervention for cases related to obesity or metabolic syndrome. A regimen of diet and exercise aimed at overall weight loss can help reduce the fat pad’s size. Regular physical activity and healthy eating support metabolic health and can prevent the accumulation from worsening.
For persistent fat pads causing significant physical or psychological discomfort, cosmetic interventions may be considered. The most common surgical approach is liposuction, which physically removes the excess fatty tissue. Surgical removal is generally reserved for specific, lasting cases, and the fat deposit can potentially return if the original cause is not fully managed.