The Dowager’s hump is an abnormal outward curvature of the thoracic vertebrae of the upper back. Compression of the front portion of the involved vertebrae due to osteoporosis leads to forward bending of the spine (kyphosis) and creates a hump at the upper back. Like most osteoporotic changes, it is often preventable.

That is what we call the Dowager’s Hump.

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

… in other words – it’s a big bump that sits at the base of your neck!

Features of a Dowager’s hump

As you can see in the picture above, there is:

  • Enlarged prominence (…that’s the Dowager’s hump!)
  • Forward rounding at the base of the neck
  • Fatty deposit tissue
  • Hyper extension of the middle neck region
  • Loss of natural spinal curve in the neck
  • Forward head posture

The main cause of a Dowager’s hump

Bad posture.

… Or more specifically, a forward head posture.

… is this your posture?

Think about how your posture looks like when you are sitting throughout the day.

If I were to guess, I’d say you spend a long time sitting down either in front of the computer, television and/or driving (… and probably with the above posture).

This is a lot of time in your bad posture.

Did you know… that for every inch  that your head protrudes forward from it;s normal alignment, you add ~10 extra pounds of force on your neck.


“How does my bad posture cause a Dowager’s hump?”

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

The result – To cater for the extra stress, the body:

a) lays on thick connective tissue and

b) thickens the bone/joint at the base of your neck.

This is the body’s attempt to support your heavy head (…which gets even heavier the more forward it is!)

After a long period of time, the thick connective tissue accumulates to an extent where a hump forms – 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. Unfortunately – we won’t be able to significantly impact these conditions.

Implications of having a Dowager’s hump

  • Aesthetics. Let’s be honest. It’s not the most appealing thing to have… But hey, at least now we can start to do something about it.
  • It can give the appearance of having a squashed neck (or lack of neck). It might even make you shorter!
  • Neck pain: As the head is in a sub-optimal position, there is more stress placed on the muscles and joints of the neck.
  • Higher risk to conditions like arthritis, disc bulges, nerve impingement, muscle spasm and headache

// How long will to take to fix?

It really depends. How long have you had your Dowager’s hump for?

The problem is… the longer you have had the Dowager’s hump, the more difficult it will become to improve it.

Your posture will not be fixed over night. But with the right corrective strategy and a bit of persistence, you will see gradual improvements. Every bit counts! Small changes add up over time.

So, the sooner you recognise you have it, the sooner we can help you fix it!

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

How to test if you have a dowager’s hump


1. Take a side profile shot of yourself:

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


2. Feel it:

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.


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! You’re looking/feeling for a significantbump.

How to fix your Dowager’s hump:

Image courtesy of stockimages at

Warning: These exercise are designed to be gentle and pain-free. 

To fix your Dowager’s hump, you will need to:

  1. Release the tight muscles
  2. Stretch the tight muscles
  3. Loosen up stiff joints
  4. Strengthen the weak muscles
  5. Address other areas

1. Release the tight muscles

These tight muscles are responsible for pulling the head into the incorrect head position.

a) Sub-occipital



  • Rest your head on a massage ball.
  • Make sure the ball is pressing on the target areas (see X target areas as above).
  • Gently rock your head from side to side.
  • Remember – If it hurts, it’s probably a tight spot!
  • Do both sides.
  • Duration: 1 minute per side.

b) Sternocleidomastoid


  • Locate the target areas. (see above)
  • You should be able to feel a prominent band of muscle on each side of the neck.
  • Do not to press too deep as you may hit other sensitive structures of the neck.
  • Gently massage these muscles with a pinch grip.
  • Duration: 1 minute each side.

2. Stretch the muscles

Now that you have released the tight muscles, it is time to stretch them!

a) Sub-occipital


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


b) Sternocleidomastoid


  • Gently tuck your chin in.
  • Look to your left and upwards.
  • Tilt your head to the right side.You should feel a stretch on the left side of the neck.
  • To increase stretch: With your right hand, apply pressure to left side of head and pull down.
  • Hold for at least 30 second. Repeat for opposite side.
  • Repeat 3 times.


3. Loosen up the stiff joints

With the Dowager’s hump, the joints in the neck will be stiff. Let’s loosen them up!

a) Head slides

Video from HowCast


  • Keep your face forward and chin parallel with the ground throughout the movement.
  • Slide your head from side to side.
  • Aim to feel a strong stretch on the side that you are sliding towards.
  • Repeat 20 times.

b) Chin tuck with over pressure


  • Lie on the floor with your knees bent.
  • Tuck your chin in.
  • Place your hands on your chin (see above) and apply a downward pressure
  • Hold for 5 seconds. Repeat 10 times.

c) Chin retraction with extension

Video from McKenzie Institute International.


  • Tuck your chin.
    • (think about the movement as a book sliding back into the shelf)
  • Whilst maintaining this position, proceed to slowly look up/down.
  • Ensure that you do not poke your chin out excessively during the movement.
  • Repeat 30 times.
  • Do NOT force this movement into pain!

d) Self neck traction

Video from Integrative Movement Specialists.


  • Lie on the floor with your knees bent.
  • Place one hand on the top of your chest, and the other hand behind your neck.
  • Proceed to pull down (towards your feet) with the hand on your chest as you pull up with the hand under your neck.
  • Aim to feel a pulling sensation at the back of your neck.
  • Hold for 10-15 seconds. Repeat 10 times.
  • Make sure that your neck muscles are completely relaxed whilst performing this exercise.

4. Strengthening exercises

If you have a Dowager’s hump, then I can guaranty that these deep muscles will be weak! (… namely the neck retractors and deep neck flexors)

If your muscles are weak, then it will very difficult to fix your Dowager’s hump.

I’ve organised these strengthening exercises in order of difficulty.

Please do not skip any exercises! (… unless you find the exercise very easy)

a) Chin tucks (lying down position)


  • Whilst lying down, tuck your chin in.
  • Try to get the back of your neck to touch the floor.
  • Hold for 5-10 seconds.
  • Repeat 20 times.


b) Chin tucks (up right position)


  • Gently tuck your chin in.
  • Keep your eyes horizontal as you tuck your chin in. (Tip: Think about this movement as the sliding of a book back into the shelf)
  • Hold for 5-10 seconds.
  • Repeat 20 times.

c) Chin tucks (with neck flexion holds)


  • Gently tuck your chin in.
  • Keep your eyes horizontal as you tuck your chin in. (Tip: Think about sliding a book back into the shelf)
  • Whilst applying a resistance to the bottom of your chin in an upward direction, press down your closed fist.
  • Hold for 5-10 seconds.
  • Repeat 20 times.

d) Chin tucks (against gravity)


  • Lie on your stomach with your head over the edge of the bed.
  • Gently tuck your chin in.
  • Hold for 30 seconds.
  • Repeat 5 times.

e) Chin tucks (with neck flexion against gravity)


  • Lie on your back with your head over the edge of the bed.
  • Tuck your chin in.
  • Keep your neck in a neutral position.
  • Hold for 5-10 seconds.
  • Repeat 20 times.

5. Addressing your posture

“So… I just do the exercises mentioned above and my Dowager’s hump will disappear?”

No!… I wish it was that simple.

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

You see… your Dowager’s hump is a part of a bigger issue… and that’s your posture as a whole.

There are reasons why you have formed that Dowager’s hump. And to completely address this issue, we need to look at all other factors as well.

There are 3 main problems (but not limited to) in your posture that predispose you to developing the Dowager’s hump.

They are:

  1. Forward head posture
  2. Hunched upper back
  3. Rounded shoulders

Collectively, they place excessive amounts of stress to the base of your neck.

Problem 1: Forward head posture

Problem 2: Hunched upper back

Exercise to fix: Thoracic extension


  • Place your outstretched hands onto a wall.
  • Lean into your hands.
  • Squeeze your shoulder blades back together
  • You should feel a) a stretch in your chest and b) the muscles between your shoulder blades contract.
  • Hold for 30 seconds.
  • Repeat 3 times.

… DON’T CHEAT! Make sure that do NOT over arch your lower back.

Problem 3: Rounded shoulders

Exercise to fix: Retraction


  • Set yourself into the starting position. (as above)
  • Pull your elbows as far backwards as you can. (end position)
  • Hold at the end range for 10 seconds.
  • Repeat 20 times.


 What to do next…

Start doing the exercises!





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