Murder Suspect Luigi Mangione Had Spondylolisthesis — What to Know About the Painful Back Condition

Luigi Mangione, the man charged with the murder of UnitedHealthcare CEO Brian Thompson, struggled with a debilitating back condition, despite having spinal surgery a year ago.

In 2023, Mangione talked openly about his back issues with former neighbors from when he lived in Hawaii, according to R.J. Martin, founder of the co-living space murder suspect resided in, the Honolulu Civil Beat reports. The 26-year-old told them he had an apparent pinched nerve.

“It can be easy to get caught up in the plethora of horror stories on the internet. When my spondy went bad on me last year (23M) it was completely devastating as a young athletic person," Mangione allegedly wrote in a Reddit post dated Aug. 3, 2023. "Spondy" is shorthand for spondylolisthesis, a rare back condition.

Martin told The New York Times that Mangione “knew that dating and being physically intimate with his back condition wasn’t possible.” He also told Today that the back pain “constantly weighed on” him.

Josiah Ryan, Martin’s spokesperson, explained that Mangione’s struggle ultimately affected his mental health. “His back pain impacted every aspect of his life, his relationships and romantic connections,” he told PEOPLE. “The constant pain led to depression, which further affected those relationships.”

A Reddit post from February 2024 seemed to confirm that Mangione had spinal surgery for the condition approximately six months earlier, or around late July or early August 2023.

However, Mangione stopped communicating with friends and family after the surgery and was reported missing to the San Francisco Police Department on Nov. 18, just weeks before he was named as the suspect in the Dec. 4 fatal shooting, according to a report by The San Francisco Standard.

Here’s what to know about spondylolisthesis and how experts say the debilitating back condition can disrupt a person’s life.

Spondylolisthesis is a condition in which a vertebra in the spine slips out of alignment and puts pressure on the vertebrae below it, according to the Cleveland Clinic. It can occur anywhere in the spine but is most common in the lower back. Symptoms of the condition include lower back pain, back stiffness, numbness or weakness in the feet, difficulty walking or standing for longer than a few minutes at a time, and sciatica (leg pain).

Spondylolisthesis is usually seen in people over 50, a symptom of natural wear and tear from aging. However, it can also be caused by sports injuries and traumas like falls or accidents.

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Dr. Uzma Samadani, a Minnesota neurologist specializing in spine surgery, told Yahoo Life that the condition can be extremely painful with little relief.

“If the nerves are pinched … putting weight on your spine can hurt a lot,” she said. “It is an excruciating pain, and it doesn’t go away with conservative management. Medications aren’t going to help, injections aren’t going to help.”

Samadani, who treats patients with spondylolisthesis, told the outlet that many insurance companies will also require six to 12 weeks of physical therapy before approving coverage for surgery or even imaging tests to diagnose spondylolisthesis. She added that physical therapy can be “excruciating” for those with severe cases of the condition and might not even be effective.

“It’s sort of like a torture, a mandatory torture imposed by the insurance company,” Samadani said.

In Mangione’s case, he spoke about his frustrations with how long it took him to get surgery on Reddit. He feared that he would be “destined to chronic pain and a desk job for the rest of my life,” the Los Angeles Times reported.

Under the username Mister_Cactus, Mangione advised others on the social media platform to exaggerate their symptoms to get the surgery sooner.

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The Cleveland Clinic states that spondylolisthesis can typically be managed with rest, over-the-counter medications, corticosteroids, physical therapy or wearing a brace. However, more severe cases of the condition require surgery.

If the condition is not diagnosed or treated, it can lead to chronic back pain, spinal arthritis, nerve damage, and trouble with bladder and bowel control.

Dr. Beth Darnall, Stanford University pain management specialist, told Yahoo Life that this type of chronic pain can deeply disrupt a person’s everyday life.

“About 10% of people have what we call high-impact chronic pain,” she said. “This is chronic pain that really impacts daily acts, school work, daily self-care. Those people are more likely to really struggle with mood, with one's ability to get restorative sleep to manage the distress and anxiety that can naturally occur with pain."

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