What Is the Fat Pad on the Upper Back?

An upper-back fat pad can be the result of an underlying condition.
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The fat pad that can accumulate at the junction of the shoulders and the base of the neck is also referred to as a buffalo hump, or clinically as a dorsocervical fat pad. For some people this is a symptom of Cushing’s Disease, also called hypercortisolism. For others, the fat pad might be a result of hypothyroidism, or is simply a part of that person's anatomy.

Dowager's Hump

    Generally the fat pad on the upper back is different from a dowager’s hump. A dowager’s hump is caused by kyphosis, which means the natural forward curve of the mid to upper spine becomes exaggerated with age. Usually a dowager’s hump is caused or exacerbated by osteoporosis and can be accompanied by scoliosis, which is an abnormal s-shaped curve in the spine. Unlike the dowager’s hump, a fat pad on the upper back generally does not cause pain.


    The thyroid gland is located in the middle to low anterior portion of the neck. It is responsible for triggering the chemicals in your body that control metabolism. Many people who are diagnosed with a sluggish thyroid, or hypothyroidism, have the corresponding physical characteristic of an upper-back fat pad. Hypothyroidism can also correspond with extreme tiredness or sluggishness, overall weight gain, thin hair and brittle nails. If you suspect that you may have hypothyroidism, contact your health professional. Sometimes mild cases can be managed with lifestyle changes, such as exercise and diet; hypothyroidism can also be managed with prescription drugs.


    Also called Cushing’s Disease, hypercortisolism is more rare than hypothyroidism. According to Mayo Clinic, less than three people in a million are diagnosed with the condition each year. The fat pad on the upper back is a clinical symptom of this condition, as well as wide red or purple stretch marks, loss of menstruation in women, a round “moon-like” face, and other distinct symptoms. The goal for treatment of hypercortisolism is to reduce high levels of cortisol back to normal in the body.


    Those who are obese often have a dorsocervical fat pad, even if they do not also have an underlying disease like Cushing’s or hypothyroidism. For those who have a dorsocervical fat pad, sometimes the biggest concern is feeling unattractive. Some opt to undergo plastic surgery or liposuction to remove the fat pad. Sometimes reducing the fat pad is as simple as losing weight. This may be impossible for those who have hypothyroidism or hypercortisolism unless they consult a doctor and make progress in getting the condition under control.

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