.What is a buffalo hump? A hump behind the shoulder, also called a buffalo hump, can develop when fat gathers together behind your neck. This condition is not necessarily serious. Tumors, cysts, and other abnormal growths can also form on your shoulders, creating a hump. Other times a hump can be the result of a curvature in the spine. You should always talk to your doctor about any physical changes to the back of your neck. What causes a hump behind the shoulders? A hump behind the shoulders can be caused by a medical condition or by medication. It may form due to: 1■a side effect of a prescription medication (such as those used to treat obesity) 2■Cushing’s syndrome (a rare condition where the body has too much of the hormone cortisol) 3■osteoporosis (a condition that leads to thin bones) 4■long-term steroid use