Dowager's Hump Is Not Just An 'Old' Problem

Dowager's Hump, or neck hump, is a fatty lump that forms at the base of the neck, making the natural curve at the neck's seventh vertebrae more noticeable.

It is often most associated with older women (hence the name), and many women dread that they, too, may be forced to shift their gazes to the ground as their posture inevitably announces their age.

However, with the age of technology giving us information at our fingertips, Dowager's Hump is shedding the notion of being an older woman's problem and is taking on a new name – text hump.

This lump on the neck, known to the medical world as kyphosis, is defined by the Mayo Clinic as an "exaggerated, forward rounding of the upper back." Kyphosis can be caused by the weakening the bones in the spine, which can cause compression.

Several medical reasons could play a role in neck hump. "Dowager's Hump is often confused with a condition that causes a similar appearance, called Buffalo hump," says Candice Price, DC, in the Wellness and Preventative Medicine Department of Cleveland Clinic in Ohio. 

She explains, "Dowager's Hump is the result of an excessive kyphosis or spinal curvature. Buffalo hump is most often a symptom of Cushing's disease. Those with Cushing's disease produce an excess of the hormone cortisol in the body."

"High levels of cortisol in the body can lead to increased fat production. This excess fat often deposits behind the neck forming what is often referred to as the 'buffalo hump,'" says Price.

Buffalo hump is sometimes also associated with glucocorticoid medication; medications used to treat HIV, Madelung's disease (a rare lipid metabolic disorder), and obesity.

"Sometimes Buffalo hump can lead to Dowager's hump, but both conditions can occur together or independently," explains Price. "Another misconception is that it is a normal part of aging and is not something to be concerned about."

Medical reasons for neck hump include:

• Osteoporosis
• Degenerative changes in the spine
• Poor posture/muscle weakness
• Congenital disorders
• Scheuermann's kyphosis, a type of kyphosis that occurs during a person's growth
• Underlying conditions of the bone or ligaments

Some symptoms that may accompany neck hump are:

• Increased pain
• Muscle fatigue in the neck/upper back
• Stiffness or tension in the neck and upper shoulders
• Burning sensation on the spine between the shoulders
• Headaches and migraines
• Noticeable forward rounding posture of the shoulders
• Forward leaning of the neck

According to Price, "Those with a parent or other close family member that has developed a Dowager's Hump are also at an increased risk of developing one themselves."

In addition, "more women have neck hump than men because women are more prone to osteoporosis due to the hormone changes during menopause," says Price, noting that women aged 50-59 are at the most significant risk for developing a neck hump. 

"During menopause women experience a sudden drop in estrogen which plays a vital role in female bone health. Women are also more prone to Cushing's disease, but there is currently no evidence regarding why the condition is more prevalent in women than men," she adds.

Neck hump, in some cases, may be preventable, according to Price. "A healthy lifestyle and regular exercise generally prevent and/or improve most diseases. Good posture practices, regular exercise, and good nutrition is vital to any healthy lifestyle." 

However, to date, there have been no widely known studies or randomized trials evaluating strategies for preventing neck hump.

Kyphosis, once labeled an older woman's problem, is now being seen in younger groups of every gender. Kyphosis is referred to as text hump, text neck, or tech neck, openly stating technology's role in the problem.

"It is now being hypothesized that we may see neck humps develop in younger populations in the future as a result of early onset cervical degenerative changes due to prolonged technology use with poor posture," says Price. "Many have coined the postural overuse syndrome associated with prolonged computer and/or cell phone use 'tech neck.'"

If you are unsure of the cause of neck hump, says Price, start with a visit to your health care provider. "The first step of treating a neck hump is determining the cause of the neck hump."

"Consulting your primary care provider, a neuro-musculoskeletal osteopathic physician, or a chiropractic physician to rule out any underlying pathologies or metabolic disorders is a great start if you are not confident that your hump is due to posture alone," she explains.

Price says that a good medical team involving a primary care provider or neuro-musculoskeletal osteopathic physician, a chiropractic physician, and a physical therapist would be ideal for helping treat the condition. 

"For posture-related neck hump, improving joint mobility, increasing muscle strength, and practicing good biomechanics (posture-friendly efficient movement) is recommended for reducing neck hump," says Price.

One can avoid posture-related neck hump by being mindful of their position while using computers or handheld technology, reading, studying, or any activity involving prolonged forward bending of the neck and upper back. 

Price notes that exercise or stretching could help prevent or improve posture-related neck humps. Exercises could include:

• Cervical retractions
• Scapular retractions
• Thoracic extensions (e.g., wall angels)
• Yoga Cat-Cow 
• Diaphragmatic breathing
• Core strengthening
• Pectoral stretches

As with many things, prevention is the most crucial step to avoiding text neck:

• Hold your phone at eye level. Refrain from staring at a horizontal phone screen or bending your neck to see your computer. Adjust the technology to accommodate the best posture.
• Sit straight and look forward to the screen, setting up the screen so your eyes naturally fall on the middle of the screen. This goes for phone screens as well.
• Take breaks from the computer screen. Move around, do some of the above mentioned exercises, or take a walk.
• Notice your posture at other times during the day, consciously pulling your spine straight. Being aware of your posture could help you remedy other physical problems. 

Rosie Wolf Williams is a freelance writer whose work has appeared in USA Weekend, Woman's Day, AARP the Magazine and elsewhere. Read More