11/26/2025
If you’ve noticed a small “hump” or bump at the base of your neck, you’re not alone. This area is often called a Dowager’s hump, but the medical term is a cervicothoracic fat pad. The good news? In most cases, it’s fixable.
What Causes the Hump?
Most of the time, it forms because of chronic forward head posture — the classic “tech neck.” When your head shifts forward, it increases stress on the neck and upper back. To protect you, the body begins to thicken the tissues at the base of the neck and upper thoracic area, while the surrounding muscles and fascia tighten. As an added protective mechanism, the body also creates a small fat cushion to prevent excessive forward movement of the head. These changes help shield the spinal cord from overstretching.
As this happens, you may notice that your neck mobility decreases. Tasks like checking your blind spot while driving or holding a phone between your ear and shoulder may become more difficult or painful.
Over time, these postural shifts create the appearance of a “hump.” When the head stays forward for long periods, the fascia and ligaments become dense and tight. There are also many lymphatic structures in this region, and forward head posture compresses that drainage, making the area look more swollen or puffy.
Most cervicothoracic fat pads improve with chiropractic adjustments and soft tissue therapy. These work best together-adjustments help free restricted joints, while soft tissue work releases the fascia, eases muscle tightness, and reduces local inflammation.
We may also give you exercises to work on at home to help speed up progress and support long-term change. Many patients notice improvement within 4–8 weeks, with significant reduction in 3–6 months of consistent care.
If you’ve noticed this hump and want help correcting it, we’d love to assess it and create a personalized plan. Give us a call!
(Written by Dr. Kelly)