Buffalo Hump vs Dowager’s Hump: What’s the Difference?
If you’ve noticed a hump on the back of your neck or upper spine, one of the first questions people ask is:
“Is this a buffalo hump or a dowager’s hump?”
They’re often lumped together online — but they’re not the same thing, and confusing them leads to the wrong advice, wrong treatments, and a lot of wasted time.
This article breaks down the real differences between a buffalo hump and a dowager’s hump, how to tell which one you’re dealing with, and when posture is actually the driver.
What Is a Buffalo Hump?
A buffalo hump refers to a fat pad that develops at the base of the neck, often associated with metabolic or hormonal factors.
It’s commonly linked to:
Long-term corticosteroid use
Certain endocrine conditions
Metabolic changes that affect fat distribution
Key characteristics:
Soft, fatty tissue
Often symmetrical
Less influenced by posture changes
Not typically reduced by exercises or posture correction
If a hump is primarily fat-based, posture work alone won’t remove it — and that’s important to recognise early.
What Is a Dowager’s Hump?
A dowager’s hump is typically posture-driven, not fat-driven.
It develops over time due to:
Chronic upper spine rounding
Forward head posture
Ribcage compression
Repeated loading of the upper back and neck in the same pattern
Rather than a fat pad, a dowager’s hump often involves:
Thickened soft tissue
Structural adaptation of the upper spine
A visible “hump back neck” appearance when viewed side-on
In these cases, the hump is less about body composition and more about how the spine is being used day after day.
Why the Confusion Is So Common
People often use terms like:
back of the neck hump
hump on neck back
back hump neck
These descriptions don’t explain why the hump is there — just where it shows up.
Because both buffalo humps and dowager’s humps appear in a similar area, they’re frequently mislabelled, which leads to:
People doing posture exercises for a metabolic issue
People chasing medical answers for a posture-driven pattern
Braces, gadgets, or massage being used without understanding the cause
Classification matters.
How to Tell Which One You Have
While only an assessment can give certainty, there are some general clues.
A hump is more likely posture-driven (dowager’s hump) if:
It becomes more obvious when standing or sitting poorly
Your posture looks rounded or collapsed from the side
You have ongoing upper back or neck stiffness
The hump feels firm rather than soft
It changes slightly with posture correction (but never fully resolves)
A hump is more likely metabolic (buffalo hump) if:
It feels soft and fatty
It hasn’t changed despite years of posture or exercise work
It appeared alongside other metabolic or hormonal changes
Many people actually have a mix — which is why guessing rarely works.
Why Exercises or Braces Often Miss the Mark
One of the most common mistakes people make is assuming:
“If I strengthen or brace the area, the hump will go away.”
In posture-driven cases, this often fails because:
Exercises don’t change how you walk, sit, or load your body
Braces don’t change the nervous system’s default posture
The upper spine keeps being reinforced into the same pattern
In metabolic cases, exercises and braces miss the issue entirely.
This is why correct classification comes before treatment.
When Posture Is the Real Driver
If a dowager’s hump is posture-driven, meaningful change requires addressing:
How the spine moves during walking
How the ribcage and pelvis interact
How arm swing and breathing influence upper-back loading
How posture is reinforced subconsciously throughout the day
This is not about “trying harder” to sit up straight.
It’s about changing the movement pattern the body defaults to.
You can read more about how posture-driven humps are assessed here:
[Dowager’s Hump & Neck Hump Assessment]
And for a broader explanation of posture patterns and treatment:
[Hunchback Posture Treatment: A Biomechanical Approach]
The Bottom Line
A buffalo hump and a dowager’s hump may look similar — but they’re driven by very different mechanisms.
One is primarily metabolic
One is primarily postural
Both require different approaches
Neither is reliably fixed by guessing or generic advice
If you’re unsure which category your hump falls into, clarity is the fastest way forward.
👉 A short phone call can help determine whether posture is actually the driver — before you waste time on the wrong solution.