How to get rid of a Dowager’s Hump

What is a Dowager’s hump?

It is an enlarged prominence that is formed at the lower region of the neck.

(… it’s a protruding bone at base of neck!)

Characteristics of a Dowager’s hump

dowager's hump

  • Excessive flexion at the Cervicothoracic junction (Hyper Kyphosis)
    • (This is the Dowager’s Hump!)
  • Hyper extension of the upper neck region
  • Loss of natural cervical spine curvature
  • Forward head posture
  • Fatty deposit tissue (Lipoma) at the base of the neck

What causes a Dowager’s hump?

Bad posture.

… Or more specifically, a Forward head posture.

forward head posture dowager's hump

 Is your neck bone sticking out AND head poking forwards?

If you are like the vast majority of people who suffer with a Dowager’s Hump, my guess would be YES.

The more forward your head sits, the more stress is placed on the base of your neck.

To cater for this extra stress, the body will respond by:

  • a) Depositing thick connective tissue (+/- fat tissue) to reinforce the area.
  • b) Stiffening the joints of the lower cervical spine in a flexed position.

(This is the body’s attempt to support your heavy head!)

After a prolonged period of time, this leads to the formation of a hump – the Dowager’s hump.


Note: There are certain conditions (namely Osteoporotic fractures and Cushing’s Syndrome) that can also cause a bump at the base of the neck. 

Disclaimer: This blog post is not intended to be used as a substitute for professional advice, diagnosis or treatment. The content provided is for informational purposes only. Use of the content provided on this blog post is at your sole risk. For more information: Medical disclaimer.

Implications of having a Dowager’s hump

a) Aesthetics

Let’s be honest. It’s not the most appealing thing to have. 

It can give the appearance of having a squashed neck. (… It might even make you shorter!)

It is also nicknamed as having a “Buffalo Hump” or “Neck Hump”.

b) Neck pain

As the head is in a sub-optimal position, there is more stress placed on the muscles and joints of the neck.

c) Higher risk to issues such as:

Can it be corrected?

Yes – as long as the joints in the neck have not already fused together, it is possible that you will be able to improve or correct this issue.

Note: If the joints have already fused, it is very unlikely that they can “un-fuse”.

How to test if you have a Dowager’s hump

Note: It is normal to have slightly enlarged bones at the base of your neck area. Do not mistake this for having a Dowager’s hump!

1. Take a side profile shot of yourself:

test for dowager's hump

If you can see an obvious bump around the base of your neck, then you most likely have it!

2. Feel it:

how to tell if you have a dowager's hump

Place your hand at the base of your neck. Can you feel a significant bump?

3. Get an X-ray:

If you really wanted to know the structural alignment of your neck, go to your general practitioner and request for an X-ray. (Check to see if the C7 vertebrae sticks out too much!)

How to fix a Dowager’s hump

Note: If you have any doubts that these Dowager’s Hump exercises will be suitable for you, make sure to consult a healthcare professional.

1. Releases

It is important to release the tight muscles which are encouraging the formation of the neck hump.

a) Upper trapezius

upper trap release ball

Instructions:

  • Locate the Upper Trapezius.
    • Use Google if you are not sure where this muscle is.
  • Place a massage ball between this muscle and a wall. (see above)
  • Apply an appropriate amount of pressure into the ball.
  • Make sure to cover the entire muscle.
  • Continue for 1 minute.

b) Posterior neck muscles

sub occipital release dowager's humpInstructions:

  • Lie down on the floor.
  • Position the muscles at the back of your neck onto a massage ball. (see above)
  • Make sure to cover the entire length of the muscle on either side of your spine.
    • Base of the skull to the base of the neck.
  • Gently rotate your head from side to side to emphasize certain areas.
  • Continue for 2-3 minutes on each side.

2. Stretches

With the Dowager’s Hump, the joints between the neck and thoracic spine will be very stiff. Let’s loosen them up!

a) Decompress the sides of the neck

neck side decompression dowager's hump

Instructions:

  • Look downwards.
  • Tilt your head to the side.
    • (“Ear to the shoulder.”)
  • Gently pull your head down towards the side.
  • Aim to feel a stretch on the side of the lower part of your neck.
  • Make sure to avoid any pinching sensation on the side you are pulling your head towards.
  • Hold for 30 seconds.
  • Repeat 3 times.
  • Do both sides.

b) Decompress the back of the hump

back of neck stretch

Instructions:

  • Tuck your chin in.
  • Whilst keeping your chin tucked in, gently pull your head downwards using both of your hands.
  • Aim to feel a stretch at the back of your lower neck.
  • Hold for 30 seconds.
  • Repeat 3 times.

c) Posterior/Lateral Neck stretch

levator scapulae stretch

Instructions:

  • Hold onto the under side of a chair with your hand.
  • Lean your body weight towards the opposite side.
  • Gently tuck in your chin.
  • Look towards the arm pit on the opposite side of the hand holding onto the chair.
  • Place your hand on the top of your head and pull your head towards the arm pit.
  • Aim to feel a stretch on the side of the neck.
  • Hold for 30 seconds.
  • For more stretches like this: Levator Scapulae Stretches.

3. Traction

The following exercises will help decompress the joints in the neck.

a) Traction (with resistance band)

traction for dowager's hump

Instructions:

  • Tie a resistance band to a stationary object. (Height: ~3-4 feet)
  • Lie on the floor with your knees bent.
  • Wrap the band under the base of the skull.
  • Whilst still holding the band with your hands, slowly shuffle your body away from the anchor point.
  • Let go and let the band pull your head.
  • Move as far away until you can feel a stretch at the back of your neck.
  • Completely relax.
  • Hold for 1 minute.
  • Note: Place a small towel between your head and the band if you feel more comfortable.

b) Traction (with a device)

Alternatively – you can invest in a mechanical traction machine which will help decompress the the joints.

4. Joint mobilization

The following exercises will get the stiff joints moving again.

a) Joint mobilization (with ball sock)

neck joint mobilization for neck hump

Instructions:

  • Place 2 massage balls into a sock. (see image)
    • Make sure that they are not too firm.
    • Tie up the end.
  • Lie on your back with your knees bent.
  • Position the Dowager’s Hump between the 2 balls.
  • Support the weight of your head using your hands at the back.
  • Pull your head forwards so that your chin in closer to your upper chest.
  • Proceed to place a comfortable amount of pressure into the ball sock by slowly lifting up your bottom of the floor.
  • Try to arch the base of the neck over the ball sock.
    • Small movements is the key here!
  • Repeat 30 times.

b) Side pressures

dowager's hump joint mobilization

Instructions:

  • Reach behind your neck with both hands.
  • Feel for the Dowager’s Hump.
  • Locate the spinous process of C7 and T1.
    • These are the bones the poke out in the middle.
  • Place your fingers tips of either side of the spinous process.
  • Apply an alternating pressure from the sides.
    • “Wiggle the bone from side-to-side”
  • Continue for 1 minute.

5. Gain control of the joints

Now that there has been more movement unlocked in the neck, it is vital to gain full control of the neck.

a) Chin tuck with extension

Instructions:

  • Look slightly downwards.
    • The more pronounced the Dowager’s Hump, the more you will need to look down.
  • Perform a chin tuck.
    • “Make a double chin”
    • (think about the movement as a book sliding back into the shelf)
  • Whilst maintaining this chin-tucked position, proceed to subtly look upwards.
  • Aim to feel a tight sensation at the base of your neck.
    • It should not hurt!
  • Do not let your chin poke forwards during this movement.
  • Repeat 30 times.
  • Do NOT force this movement into pain!
    • If you feel any pain, ease off your tension.

6. Address Forward Head posture

poked neck

A Forward Head Posture is where the position of the head is in front of the mid line of the torso.

Since the head is relatively heavy, the further forward it is positioned, the more pressure it places on the base of the neck.

I have listed a few exercises below to address this specific postural issue, but it is strongly recommended that you check out the FULL blog post as linked below:

For more information: How to fix Forward Head Posture

Here are some exercises to get you started

a) Sternocleidomastoid release

scm release

Instructions:

  • Locate the Sternocleidomastoid
    • You should be able to feel a prominent band of muscle on each side of the neck. (see above)
  • Gently massage these muscles with a pinch grip.
  • Do not press too deep!
  • Duration: 1 minute each side.

b) Sub-occipital

sub occipital stretch

Instructions:

  • Place one hand at the front of your chin and the other at the back of your head.
  • Apply a force to the front of your chin as to gently glide the chin backwards.
  • Whilst maintaining this pressure, proceed to pull your head forward/down.
  • Aim to feel a stretch at the back of your neck.
  • Hold for 30 seconds.
  • Repeat 3 times.

c) Sternocleidomastoid stretch

sternocleidomastoid stretch

Instructions:

  • Gently tuck your chin in.
    • (Keep this position throughout the movement.)
  • Rotate your head towards the side you want to stretch.
  • Tilt your head to the side away from the side you want to stretch.
  • Use your hand to pull your head further into the tilt.
  • Aim to feel a stretch on the side of your neck.
  • Hold for 30 seconds.
  • Repeat 3 times.

(For more stretches like this: The best Sternocleidomastoid stretches.)

d) Chin Tuck

chin retraction and nod

Instructions:

  • Whilst sitting upright, gently tuck your chin in.
    • “Make a double chin.”
  • Aim to feel a gentle lengthening sensation at the back of your neck.
  • A common mistake I often see is the person starts to move their head up/down. Make sure your eyes and jaw stay level, and move the head horizontally backwards.
    • Think of the movement like a book sliding back into the shelf.
  • Hold for 5 seconds and repeat 30 times.

e) Chin nods

deep neck flexor strengthening exercise

Instructions:

  • Sit up right.
  • Slightly nod your chin downwards.
  • Place a closed fist underneath your chin.
  • Gently push your chin down onto your fist
  • Hold for 30 seconds.
  • Aim to feel a gentle contraction at the front of your throat.
  • Repeat 2-3 times.

f) Chin tuck/nod with head lift

advanced deep neck flexor exercise for Dowager's hump

Instructions:

  • Lie down on your back with your knees bent.
    • (Support your head on a pillow if required.)
  • Gently flatten your tongue to the roof of your mouth throughout the exercise.
    • This will help engage the appropriate muscles.
  • Tuck your chin in.
  • Nod your chin downwards.
  • Whilst keeping your chin in the nodded position, lift your head off the ground.
    • Imagine you are gently squashing an apple between your lower jaw and throat throughout movement.
  • Lift as high or as low as you are comfortable.
  • Aim to feel the contraction of the muscles at the front of your neck.
  • Hold for 5-10 seconds.
  • Repeat 10 times.
  • Make sure that you DO NOT let your chin jut forward

Note: If you find this exercise difficult, use your finger tips at the back of the head to provide as much support as required.

7. Maintaining the Correct head position

Here are some simple cues to help remind you to hold your head in the correct position.

a) Aim to keep your neck tall and elongated.

“Float your head away from your shoulders”

b) Maintain a gentle chin nod at all times. Do not allow for your chin to poke forwards.

“Imagine gently holding a large apple between your chin and upper chest” 

8. Addressing your posture

Although the exercises mentioned above will definitely help address your Dowager’s Hump, there are other factors that we must consider!

The 2 other postural issues that predispose you to developing the Dowager’s hump:

  1. Hunched upper back
  2. Rounded shoulders

Collectively – they place an increased amount of stress to the base of your neck.

a) Address Hunchback Posture

slouching dowager's hump

If the thoracic spine (upper back) is hunched forwards, it can force the head to poke forwards.

The weight of the head in this forward position will place extra stress at the base of the neck.

For more information: How to fix a HunchBack Posture

b) Address Rounded Shoulders

rounded shoulders

Having Rounded Shoulders is when the resting shoulder position is in front of the mid line of the torso.

Together with the weight of the arms, this forward resting position of the shoulders can cause the upper trapezius to pull on base of the neck.

For more information: How to fix Rounded Shoulders

9. Tips

a) Sitting

Avoid slouching!

Being in a hunched position for a prolonged amount of time will naturally place more stress at the base of your neck.

Sit tall. Elongate your spine. And avoid poking the chin forwards.

b) Driving

poor driving posture

Generally speaking – car seats do not encourage a good driving posture. (see above)

If you need to drive on a consistent basis, the main thing is to set up the seat to give the opportunity for your body to maintain the best possible posture.

If you would like some posture tips for driving, be sure to check out this post: Proper Driving Posture.

c) Sleeping

How do I fix a Dowager’s Hump while sleeping?

The main issue is when you sleep on your back. (see below)

dowager's hump sleeping position

If you sleep on your back, avoid using an excessively thick pillow as this will push your head forwards and encourage the bump!

The aim is to use the thinnest pillow as comfortably possible without letting your chin jut forwards.

10. Common questions:

a) How long will to take to fix?

It really depends… Everybody is different!

However – if you have had your Dowager’s Hump for a long time, it is more likely to be more difficult to improve it.

There are no quick fixes!

Commit your time. Do the exercises. You WILL see improvements!

b) Can surgery fix Dowager’s Hump?

The Dowager’s Hump removal involves surgically removing the fatty tissue deposits that sits around the hump.

Although this may reduce the appearance, the hunched position of the joints will remain unchanged.

c) Can wearing a heavy bag contribute?

Yes!

… Especially if you already have Rounded shoulders!

The weight of the bag will place extra stress at the base of the neck.

11. Conclusion:

  • The Dowager’s Hump is the bump at the base of your neck.
  • The main cause is a Forward Head Posture.
  • It is able to be improved… unless the neck joints are already fused.
  • Initially – it is important to do all of the exercises mentioned in this blog post. From here – focus on the exercises that give you the best results.
  • It is recommended to address your whole posture.

What to do next…

1. Any questions?… Leave me a comment down below.

2. Come join me on the Facebook page. Let’s keep in touch!

3. Start doing the exercises!


About Mark Wong:

Mark is a Physiotherapist who has been helping his patients fix their posture for the past 11 years. He created the Posture Direct blog in 2015 with the goal of helping people fix their own posture.

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630 thoughts on “How to get rid of a Dowager’s Hump”

  1. Any tips on relieving the chronic pain in the hump please? Will these exercises help ease the pain? It’s not responding to any pain killers.

    Reply
    • Hi Bahaa,

      The first step would be to minimize your exposure to postures/positions/activities that may be increasing your symptoms in this area.

      The next step would be to get your neck moving. You can perform gentle and pain-free range of motion exercises for your neck. This will include rotation, lateral flexion, flexion/extension, retraction/protraction.

      If you are like most people, you might need to focus on stretching/decompressing this area. This is generally achieve with flexion stretches and/or traction.

      Once your pain levels have subsided, you can persist with the mentioned exercises on this blog post to see if you can address the bump directly.

      Mark

      Reply
  2. Hi Mark,

    My hump sometimes gets very painful. Done MRI and Xray and report says it’s loss of cervical curvature. No fuse, and I’m 32 old.

    1. Should I use neck pillow with these exercises?

    2. Is it usually painful? My PT says trapezius muscles are very tight. And I’ve started doing your exercises and I find myself in relief after the session. So thank you for making them!

    3. Can you please do exercises for straightening of lumbar spine due to muscle spasm? 7 years now with low back pain and having 2 chronic pain isn’t making my life easier.

    Thank you!

    Reply
    • Hi Pulafagu,

      I wouldn’t recommend massaging directly onto the bony prominence as this could bruise/injure the bone.

      You can massage the muscles around the vertebra.

      Mark

      Reply
  3. Hi Mark! I have slouched all my life. I have now developed a forward head posture, rounded shoulders and a hump at the base of my neck. There are lots of exercises, should I start with one (for instance, the forward head posture) and then move on to another one if the forward head gets better? Thanks

    Reply
    • Hey Amanda,

      With multiple areas, I would generally advise to start on one area, get the most out of it, then move onto the next area.

      You will start know which exercises are the main ones which are helping you. In this case – you can just do those and not all of the exercise mentioned on my blog posts.

      All the best!

      Mark

      Reply

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