A hump behind your shoulders, sometimes called a buffalo hump or dorsocervical fat pad, is a buildup of fat behind and slightly below your neck. It can result from hormone issues or medication side effects. Common causes include long-term use of corticosteroid medicines, Cushing’s syndrome (excess cortisol in the body), and obesity. The hump may also be due to spinal compression fractures from osteoporosis. Treatment depends on the specific cause and may include adjusting medications, treating osteoporosis (e.g., calcium and vitamin D supplements), surgically removing tumors, and lifestyle changes like improving posture and weight loss.