What is the disease where you have a thick neck?

September 29, 2025 •

5 min read

According to the Cleveland Clinic, the medical term for a thick, fatty lump at the back of the neck is dorsocervical fat pad hypertrophy, more commonly known as a buffalo hump. Understanding what is the disease where you have a thick neck is crucial, as this condition can be a symptom of various underlying health issues, ranging from hormonal disorders to rare genetic conditions.

Quick Summary

A thick neck, often appearing as a fatty deposit called a buffalo hump, is most commonly associated with Cushing's syndrome, a disorder of excess cortisol, or Madelung's disease, a rare metabolic condition. It can also be caused by medication side effects, obesity, or an enlarged thyroid gland (goiter).

Key Points

Cushing's Syndrome: Caused by excess cortisol, this condition frequently leads to a fatty deposit known as a buffalo hump on the neck and upper back.
Madelung's Disease: This rare disorder is characterized by the symmetrical accumulation of large, unencapsulated fat masses, particularly around the neck and shoulders.
Goiter: An enlarged thyroid gland, or goiter, can cause noticeable swelling at the base of the neck due to factors like iodine deficiency or autoimmune disease.
Obesity and Sleep Apnea: Central obesity can cause excess fat in the neck, which is a major risk factor for developing obstructive sleep apnea.
Diagnostic Testing: A doctor may use physical exams, lab tests for hormone levels, and imaging like ultrasounds or MRIs to determine the underlying cause of a thick neck.
Treatment Varies: The approach to treatment depends entirely on the root cause and can range from adjusting medication and weight loss to surgery or other medical therapies.

Understanding a Thick Neck: More Than Just Appearance

While a thick neck can sometimes be linked to obesity, it is also a hallmark sign of several significant medical conditions. A fatty deposit on the upper back and neck is medically termed a dorsocervical fat pad or, more popularly, a "buffalo hump". This article explores the primary medical conditions that can cause a thick neck, their associated symptoms, and the diagnostic steps healthcare providers may take.

Cushing's Syndrome: The Cortisol Connection

Cushing's syndrome is a condition caused by prolonged exposure to high levels of the hormone cortisol. Excess cortisol can be produced by the body itself, often due to a tumor on the pituitary or adrenal glands, or it can be a side effect of long-term use of corticosteroid medications like prednisone. The buildup of fat in the neck and upper back is a classic symptom of this disorder.

Other symptoms of Cushing's syndrome include:

Weight gain, particularly in the abdomen and face (causing a "moon face"), with thinner arms and legs.
Skin changes, such as easy bruising and purplish stretch marks (striae).
Muscle weakness and fatigue.
High blood pressure and elevated blood sugar levels.
Mood changes, including anxiety and depression.
Excess hair growth (hirsutism) in women.

If Cushing's syndrome is caused by a tumor on the pituitary gland, it is specifically referred to as Cushing's disease. Proper diagnosis often requires a combination of physical examination, review of medical history, and lab tests to measure cortisol levels.

Madelung's Disease: Rare Fat Accumulation

Madelung's disease, also known as multiple symmetric lipomatosis (MSL) or Launois-Bensaude syndrome, is a rare disorder characterized by large, unencapsulated fat deposits. These fatty tumors commonly appear symmetrically around the neck, shoulders, and upper arms, but can also affect other parts of the body. The growths are typically painless but can cause functional issues.

Key characteristics of Madelung's disease often include:

Localized, non-painful masses of fatty tissue.
Potential for difficulty speaking, swallowing, or breathing if the masses compress surrounding structures.
Most commonly affects adult males between 30 and 70, often with a history of excessive alcohol consumption.
The condition is more prevalent in Mediterranean and European populations.

Unlike the more diffuse fat deposition in Cushing's syndrome, Madelung's disease involves specific, distinct masses.

Goiter: The Thyroid Gland Connection

A goiter is an abnormal, non-cancerous enlargement of the thyroid gland, which is located in the neck below the Adam's apple. Depending on the size and shape, a goiter can cause the neck to appear noticeably thicker or swollen.

Causes of a goiter include:

Iodine deficiency, a historical and still relevant cause in some parts of the world.
Autoimmune thyroid conditions, such as Graves' disease (overactive thyroid) or Hashimoto's thyroiditis (underactive thyroid).
Thyroid nodules or tumors.

While a goiter is often painless, a large one can cause compressive symptoms, including difficulty swallowing, a choking sensation, or a change in voice.

Other Potential Causes

A thick neck can also be a symptom of other less common or generalized conditions:

Obesity: Central obesity, where fat is stored disproportionately around the torso, face, and neck, can lead to a thick neck. This is a significant risk factor for obstructive sleep apnea.
Obstructive Sleep Apnea (OSA): A large neck circumference is a major risk factor for OSA, a sleep disorder where breathing is repeatedly interrupted. Excess fat tissue can crowd the airway, leading to obstruction during sleep.
Certain Medications: Some medications, particularly older antiretroviral drugs used to treat HIV, can cause lipodystrophy (abnormal fat distribution).
Lymphadenopathy: Swollen lymph nodes in the neck, caused by infections, autoimmune diseases, or cancer, can also cause localized swelling.

Diagnostic Approaches for a Thick Neck

Determining the cause of a thick neck requires a comprehensive medical evaluation. A doctor will typically perform the following:

Physical Examination: Visually inspecting and palpating the neck to feel for fatty deposits, enlarged glands, or nodules.
Medical History: Reviewing past and current health conditions, medication usage, and family history.
Laboratory Tests: For suspected hormonal issues like Cushing's syndrome, tests for cortisol levels (blood, urine, or saliva) may be ordered. Thyroid function tests (TSH, T4) can diagnose goiter.
Imaging Studies: An ultrasound may be used to examine the thyroid gland. CT or MRI scans can help differentiate between fat deposits (buffalo hump) and spinal curvature (Dowager's hump) or locate tumors.

Comparison of Conditions Causing a Thick Neck


Feature	Cushing's Syndrome	Madelung's Disease	Goiter	Obesity (Central)
Cause	Excess cortisol from glands or medication.	Unknown (genetic), often linked to alcohol use.	Enlarged thyroid gland (iodine, autoimmune).	Excessive fat accumulation.
Appearance	Diffuse fat pad (buffalo hump) on upper back/neck.	Symmetrical, specific fat masses.	General neck swelling at the base.	Overall fat accumulation, including neck area.
Other Symptoms	Weight gain (abdomen/face), easy bruising, fatigue, muscle weakness.	Painless, but can cause breathing/swallowing issues.	Difficulty swallowing/breathing (if large), hoarseness.	Sleep apnea, cardiovascular risk factors.
Commonality	Rare.	Very rare.	Common, especially in iodine-deficient areas.	Very common.
Treatment	Addressing the underlying cause (medication, surgery, radiation).	Surgical removal (lipectomy or liposuction).	Varies (radioactive iodine, surgery, medication).	Diet, exercise, and lifestyle changes.

When to See a Doctor

While some cases of a thick neck may be harmless, it is important to consult a healthcare professional to rule out serious conditions. If the neck thickening is accompanied by any of the other symptoms of Cushing's syndrome, or if you notice distinct fat masses, difficulty swallowing, or changes in your voice, seek medical advice promptly. Early diagnosis and treatment can prevent more severe complications.

Conclusion

For those asking what is the disease where you have a thick neck, there isn't a single answer. A thick neck, especially the appearance of a fatty buffalo hump, can be a symptom of conditions ranging from the hormonal imbalance of Cushing's syndrome to the rare genetic fat disorder Madelung's disease. Furthermore, thyroid issues like goiter and general obesity are also common culprits. Accurate diagnosis by a medical professional is crucial to identify the root cause and ensure proper treatment. Recognizing the associated symptoms and understanding the potential underlying health risks is the first step toward effective management and care. To learn more about endocrine disorders like Cushing's syndrome, visit the National Institute of Diabetes and Digestive and Kidney Diseases.

Frequently Asked Questions

The medical term for the fatty lump on the back of the neck that can cause it to appear thick is dorsocervical fat pad hypertrophy, more commonly referred to as a buffalo hump.

A thick neck can be associated with metabolic risk factors like insulin resistance and type 2 diabetes. High levels of cortisol from Cushing's syndrome can lead to diabetes, which is also associated with a thick neck.

Yes, a thick neck is a significant risk factor for obstructive sleep apnea. Excess fat tissue in the neck area can narrow the airway, causing interrupted breathing during sleep.

Diagnosis depends on the suspected cause. A doctor will typically perform a physical exam, review medical history, and may order lab tests for hormone levels or imaging studies like an MRI or ultrasound to investigate the root cause.

If the thick neck is caused by obesity, weight loss may help to reduce the size of the fatty deposit. However, if an underlying medical condition like Cushing's or Madelung's disease is the cause, weight loss alone may not be sufficient, and specific medical treatment is needed.

A buffalo hump is a buildup of fatty tissue. A Dowager's hump, medically known as kyphosis, is an excessive curvature of the spine in the upper back, often due to osteoporosis or poor posture.

Yes, long-term use of certain medications, particularly corticosteroids (like prednisone) and some older antiretroviral drugs for HIV, can cause a thick neck due to abnormal fat distribution.