What is exactly a neck hump?

A neck hump is traditionally seen in older women, but also in men and occasionally younger adults. In the medical world, this is referred to as a postural kyphosis and a neck hump as a hyperkyphosis. Hyperkyphosis (the area of the C7 vertebra) has significant roundness and fatty deposits at the lower region of the neck. The neck hump itself is not necessarily painful, however, the presence of hyperkyphosis can play a major role in the individual experiencing neck, shoulder, and upper back pain due to the position of the head and the resulting strain on any supporting soft tissues and joints. In addition to any associated pain and discomfort, hyperkyphosis causes patients to become embarrassed about their appearance. The image shown below demonstrates hyperkyphosis, with a visible loss of the natural spinal curve in the neck, i.e. forward rounding at the base of the neck and the presence of fatty tissue deposit.

Causes of hyperkyphosis

Poor posture over an extended time usually plays a role here. When your head sits forward from its normal neutral anatomic position there is increased stress placed on the base of the neck. Subsequently, as a result of prolonged forward head posture and the resulting increased stress on the base of the neck, connective tissue, bone and joint changes occur. Over time, the fat tissue thickens in an attempt to support the extra load through the neck which ultimately leads to the formation of the recognizable hump. Similar to developing callous tissue on your hands or feet from the repetitive rubbing that may occur in shoes, or associated with manual work or lifting activities at the gym, the skin of the hands or feet adapt over time by accumulating more and more tissue leading to callouses. A similar thing happens when you have a poor posture over years, which contributes to changes around the base of the neck.

Forward head posture is becoming increasingly more prevalent in younger individuals due to the increased use of electronic devices and the time spent in front of screens. When operating electronic devices or reading a book they often curl up even more which worsens the problem.

· In the older population with low bone density more severe cases of hyperkyphosis may lead to vertebral fractures and degenerative discs. These changes can cause segments of the spine to “collapse”, further worsening the appearance of the “hump” and potentially causing more discomfort along the way.