UnitedHealthcare CEO killing: Did suspect Luigi Mangione’s intense back pain drive him to murder?

A 26-year-old Ivy League graduate’s arrest in the United States in connection with the murder of UnitedHealthcare CEO Brian Thompson has raised curiosity about the motive of the crime. Luigi Mangione was apprehended by the police Monday (December 9) at a McDonald’s in Altoona, Pennsylvania for the “targeted” shooting of the healthcare executive in New York City last week.

Mangione, who earned bachelor’s and master’s degrees in computer science in 2020 from the University of Pennsylvania, has been charged with murder in New York, along with four more charges including illegal gun possession.

Now, reports have surfaced that Mangione was suffering from chronic back pain and underwent surgery earlier this year. After the painful treatment, he cut off contact with his family and friends.

Let’s take a closer look.

Luigi Mangione’s back issues

Luigi Mangione reportedly suffered from “debilitating” back pain and had undergone spinal surgery last year.

Speaking to Honolulu Civil Beat, RJ Martin, the founder of a co-living space in Hawaii called Surfbreak, said Mangione lived there for about six months until April 2022.

He said the Mangione moved to the community, which is near Honolulu’s Ala Moana Beach Park, to get as healthy as possible before his surgery.

Explaining the engineer’s back issues, Martin said, “His spine was kind of misaligned. He said his lower vertebrae were almost like a half-inch off, and I think it pinched a nerve. Sometimes he’d be doing well and other times not.”

Martin told New York Times (NYT) that his problem worsened while surfing. “For some reason, the motion—the arching, the looking up—was just the wrong thing for his back. He was in a lot of pain.”

He recalled to CNN that after taking one surf lesson, Mangione ended up “in bed for about a week” with back pain.

The Surfbreak founder added that Mangione’s back pain also impacted his personal life. “He knew that dating and being physically intimate with his back condition wasn’t possible. I remember him telling me that, and my heart just breaks.”

Martin, however, does not remember Mangione being on any pain medication.

The Surfbreak founder told Honolulu Civil Beat that Mangione left the co-living space in mid-2020 and the duo stayed in touch.

Later, Mangione texted him images of his spinal surgery, with Martin asking how the surgery went. To this, Mangione replied “long story” without offering further details.

Describing the photo of an X-ray of Mangione’s back, Martin said it “looked heinous, with just giant screws going into his spine.”

As per Independent, Mangione’s X account, which has since been taken down, showed a picture of a spine with four pins in it.

Martin said that then this summer the engineer went “radio silent”.

Reports say the murder suspect lost touch with his family and friends this year. Law enforcement sources told the New York Post that Mangione’s mother reported him missing on November 18, possibly from San Francisco.

Reddit and spondylolisthesis

Mangione reportedly opened up about his health issues online. As per ABC News, he shared his health troubles including back pain, brain fog, and sciatica on his Reddit profile.

Many posts made on a subreddit were about the spinal condition Spondylolisthesis.

Spondylolisthesis is when “one vertebral body slips with respect to the adjacent vertebral body causing radicular or mechanical symptoms or pain,” according to the National Institutes of Health (NIH).

It usually occurs in the lower back and those with a high-grade slip are more susceptible to experiencing “significant pain” and “nerve injury”. They require surgery to relieve symptoms, as per the American Academy of Orthopaedic Surgeons.

A post on the r/Spondylolisthesis subreddit dated February 2024 suggests that Mangione had undergone surgery six months earlier.

“Yea I had L5/S1 spinal fusion six months ago after 1.5 years of failed conservative treatment. Within seven days of the fusion I was on zero pain meds. (That’s probably faster than most folks, but my point is just that your body isn’t supposed to be in pain and need meds. Even after getting my back sliced open and my spine drilled into, I wasn’t in much pain),” the post read.

As per Independent, the engineer’s Goodreads account shows five books related to chronic back pain on his reading list: Crooked: Outwitting the Back Pain Industry; Getting on the Road to Recovery; Why We Get Sick: The Hidden Epidemic at the Root of Most Chronic Disease and How to Fight It.

The list also included several books about alternative medicine and psychedelics.

ALSO READ: Is there a ‘link’ between UnitedHealthcare CEO’s murder and book criticising insurance companies?

Manifesto berating US healthcare system

Mangione was arrested Monday after a McDonald’s employee in Altoona, Pennsylvania called the police after identifying him from images of the suspect shared by the NYPD last week.

Police say the murder suspect had a hand-written manifesto of grievances against America’s “most expensive health care system in the world.”

The manifesto indicates Mangione was angered by the expensive and sometimes dysfunctional US health care system.

“I had an opportunity to read the manifesto,” New York police chief detective Joseph Kenny said on the Good Morning America TV show.

According to the police, Mangione criticised how the US health care system was one of the most expensive globally and still the country has a lower life expectancy than other developed nations.

“He was writing a lot about his disdain for corporate America and in particular the health care industry,” Kenny told ABC.

With inputs from agencies