A dowager's hump is a forward rounding of the upper back that creates a hump at the base of the neck. Doctors call an extreme version of this curve hyperkyphosis. It usually comes from long-term posture habits and weak upper-back muscles, and sometimes from osteoporosis, when weakened vertebrae compress and tilt forward. Unlike a buffalo hump, it's a change in the curve of the spine, not a fat deposit.
Below: what it is, how to tell it from a fat hump, what causes it, who gets it, and what helps.
Key takeaways
- A dowager's hump is a forward curve of the upper spine at the base of the neck, not a fat deposit.
- Posture and weak upper-back muscles are the most common cause; osteoporosis is another.
- Physical therapy, targeted exercise and good posture habits help posture-related humps over months.
- See a doctor if the curve gets worse quickly or you have back pain after a minor fall.
What is a dowager's hump?
Your spine has natural curves that help you stand upright. Kyphosis is when the upper spine curves too far forward, and hyperkyphosis is when that curve is extreme. A dowager's hump is the visible result: a rounded hunch at the base of the neck, with your head pushed forward.
Cleveland Clinic suggests a simple check. Look at your profile in a mirror: your back may look rounded and your head may jut forward. Along with the hump, you may notice:
- rounded shoulders
- tight hamstrings
- pain or stiffness in your back and shoulder blades
- tiredness
- headaches
"Neck hump" is the everyday name, and people use it for more than one condition. That's why the next question matters.
Is a dowager's hump fat or bone?
A dowager's hump comes from the shape of your spine, not fat. It's often mistaken for a buffalo hump, which looks similar but is a pad of fat behind the neck.
| Dowager's hump | Buffalo hump | |
| What it is | A forward curve of the upper spine (kyphosis) | Fat deposited at the back of the neck |
| How it feels | Firm; you're feeling the curve of the spine | Usually soft |
| Changes with posture? | Often looks smaller when you stand tall | Little change |
| Common causes | Posture, weak upper-back muscles, osteoporosis | Body weight; Cushing's disease, where the body makes too much cortisol |
| What helps | Exercise, posture, physical therapy, bone health | Weight management and treating the cause |
Cleveland Clinic notes that the two can occur together or on their own. For a step-by-step version, try our self-check for a fat or posture hump. If yours sounds like a fat pad, read our guide to buffalo hump and weight loss.
What causes a dowager's hump?
"Bad posture is the most common cause of a dowager's hump," says Dr. Price, quoted by Cleveland Clinic. Weak muscles in the upper back and neck, plus tight muscles in the neck and chest, pull you into the forward-leaning shape. Nebraska Medicine adds that leaning down to look at a phone or computer, and how you sit at work, contribute.
Other causes include:
- Osteoporosis. A compression fracture in a weakened vertebra increases the forward curve of the upper back.
- Degenerative changes. Gradual wear in the spine, usually with age.
- Other conditions affecting the bones or ligaments of the spine, such as infections, fractures or tumors (rare).
- Scheuermann's kyphosis. Appears in teenagers, when vertebrae develop a wedge shape.
- A congenital problem, where the spine doesn't form properly before birth (rare).
Forward head posture often goes hand in hand with a dowager's hump. Our guide to fixing forward head posture covers that side.
Who gets it
A dowager's hump usually shows up around middle age. Women are more likely to develop one, because hormone changes during menopause raise the risk of osteoporosis. Nebraska Medicine notes that hunching caused by osteoporosis tends to appear in older patients and develops slowly. Posture-related humps can start earlier, especially in people who spend long hours at a desk or on their phones.
Symptoms to watch for
According to Nebraska Medicine, common signs include:
- your head sitting in a forward position
- a visible hump at the top of your back, at the base of your neck
- pain in your neck and upper back, especially with certain movements
- pain and stiffness around your shoulder blades
- in severe cases, difficulty looking up
Cleveland Clinic notes that an extreme curve is linked with reduced lung function and reduced ability to do everyday activities.
What helps with dowager's hump
Start by finding the cause. Cleveland Clinic advises seeing your primary care provider first to rule out underlying issues.
For posture-related humps, the main treatment is retraining your posture by stretching and strengthening the muscles of your upper back and neck. That often means 6 to 8 weeks with a physical therapist, then continuing on your own. Cleveland Clinic suggests three exercises:
- Chin tucks: pull your chin straight back. 3 sets of 10 daily.
- Shoulder blade squeezes: squeeze your shoulder blades together. 3 sets of 10 daily.
- Doorway chest stretch: arms in a goalpost shape on a door frame, step forward and hold 20 to 30 seconds, 2 to 3 times a day.
Research supports this approach. In a randomized trial of 99 adults aged 60 to 88, six months of spine-strengthening exercise and posture training reduced the forward curve of the upper back compared with a group that didn't do the program. A review of 10 trials found exercise had a large effect on the upper-back curve, with strengthening looking more useful than stretching alone. For a full daily routine and habit changes, see our guide on how to get rid of a neck hump.
For humps related to osteoporosis, your provider will look at treating the bone loss first, alongside physical therapy. Keeping osteoporosis from getting worse helps prevent the compression fractures that increase the curve.
Supportive tools. Some people add a neck-care session to their routine. The Callixe Thera Pillow combines air-powered neck traction, heat and vibration massage. It can support the habits above, but it doesn't replace exercise or treatment for the cause.
A cervical pillow with 3 modes: air-powered neck traction, heat and vibration massage.
$129.00Expect gradual change. Cleveland Clinic cautions that a dowager's hump won't go away overnight and can take months to improve.
Best sleeping position for dowager's hump
Sleep on your back or side with a pillow that supports the natural curve of your neck, so your head isn't pushed forward. Avoid stacking pillows so high that your chin drops toward your chest. Our guides to the pillow for dowager's hump and the sleep setup for rounded shoulders go into detail.
When to see a doctor
See your doctor if:
- the curve is getting worse quickly
- you have back pain after a minor fall or bump (a possible compression fracture)
- you're losing height
- you have numbness, tingling or weakness
You can also ask whether a bone density scan makes sense for you, especially after menopause.
How to get rid of a neck hump: a daily routine
If your hump is posture-related, a short daily routine and a few desk and phone changes make the biggest difference. Read our step-by-step guide on how to get rid of a neck hump.
FAQ
Can a dowager's hump be reversed?
Depending on your age and how severe it is, a dowager's hump can often be improved, and sometimes reversed, by strengthening your upper back and neck. Changes caused by fractures or other problems in the bones may not fully reverse, so ask your doctor what to expect.
How long does it take to reduce a neck hump?
Months rather than weeks. Our neck hump guide covers timelines in more detail.
Is dowager's hump genetic?
Most dowager's humps come from posture and, later in life, osteoporosis. A few causes start early in life, such as Scheuermann's kyphosis in teenagers or a congenital problem with the spine.
Can you get a dowager's hump in your 20s or 30s?
Yes. Posture-related humps from long hours looking down at phones and computers aren't limited to older adults. The same exercises and habits help at any age.
This article is for general information and isn't a substitute for advice from your doctor or physical therapist. If you're unsure about your symptoms, get them checked.
Sources
- Cleveland Clinic Health Essentials, "Dowager's Hump: What It Is and How To Get Rid of It." https://health.clevelandclinic.org/how-you-can-fix-a-dowagers-hump-prevention-tips (accessed 4 Nov 2026)
- Nebraska Medicine, "What is a Dowager's hump, and how can I prevent it?" https://www.nebraskamed.com/health/conditions-and-services/orthopaedics/what-is-a-dowagers-hump-and-how-can-i-prevent-it (accessed 4 Nov 2026)
- Houston Methodist, "How to Get Rid of a Neck Hump" (16 Oct 2024). https://www.houstonmethodist.org/blog/articles/2024/oct/how-to-get-rid-of-a-neck-hump/ (accessed 4 Nov 2026)
- Katzman WB, et al. "Targeted spine strengthening exercise and posture training program to reduce hyperkyphosis in older adults: results from the study of hyperkyphosis, exercise, and function (SHEAF) randomized controlled trial." Osteoporos Int. 2017;28(10):2831-2841. PMID 28689306. https://pubmed.ncbi.nlm.nih.gov/28689306/
- González-Gálvez N, Gea-García GM, Marcos-Pardo PJ. "Effects of exercise programs on kyphosis and lordosis angle: A systematic review and meta-analysis." PLoS One. 2019;14(4):e0216180. PMID 31034509. https://pubmed.ncbi.nlm.nih.gov/31034509/
