'Surgery was painful': UnitedHealthcare CEO killer Luigi Mangione's social media posts indicate about his health struggles

Social media posts of Luigi Mangione, who was detained as a suspect in the killing of UnitedHealthcare CEO Brian Thompson, give an insight into his physical and mental health issues.
Last year, following his spinal surgery for chronic back pain, he became an advocate for the procedure that positively transformed his life. He actively encouraged individuals facing similar conditions, to challenge medical professionals who suggested pain was inevitable.
His Reddit posts discuss spondylolisthesis, a spinal condition where vertebral fractures cause misalignment. This can lead to severe pain when nerves are compressed.
According to his social media posts, this condition, which can develop during childhood or through injury, began significantly affecting Mangione's life in recent years.
Following his studies at the University of Pennsylvania, where he obtained bachelor's and master's degrees, he was employed at TrueCar, a Santa Monica-based car-buying website until 2023. He resided in Hawaii beginning January 2022. His back condition deteriorated, partly due to a surfing incident during his six-month residence at Surfbreak, a "co-living" accommodation in Honolulu.
According to Josiah Ryan, who speaks for Surfbreak's owner and founder R.J. Martin, Mangione increasingly voiced concerns about his pain. The condition affected his ability to participate in recreational activities and exercise, and he worried about its impact on potential romantic relationships.
"That was definitely a theme in his time there," Ryan said. "He wasn't a big complainer. So it wasn't like he was bringing it up constantly. But the people who knew him knew this was a significant part of his life."
In July 2023, Mangione shared on Reddit his decision to undergo surgery.
"I got caught in this loop for a year, all the while putting my life on hold in my 20's and damaging my nerves while I waffled on the decision. I have surgery scheduled in two weeks and I keep wondering why I was so afraid of it," he wrote.
His posts indicated the procedure was successful. His X account displayed what seemed to be an X-ray showing a metal rod and multiple screws inserted in his lower spine.
"Surgery was painful for the first couple days, but I was shocked that by day 7 I was on literally zero pain meds," Mangione posted on Reddit in August 2023. "Obviously will be awhile until I get into rigorous activity, but it was way less of a big deal than I had anticipated."
In a post from July 2018, he discussed his academic challenges and thoughts of leaving university. However, he noted that "staying in college has at least let me maintain some semblance of normality."
His final Reddit contribution was on May 17, with surrounding posts indicating stability and no apparent health complications. He appeared supportive of the surgical procedure he had undergone previously.
In early April, he shared details about equipment chosen for an extended Asian backpacking adventure involving motorcycle travel, describing it as having "the perfect balance between minimalism and practicality."
Later that month, he offered advice to another Reddit user experiencing back issues, suggesting persistent consultation with different surgeons and emphasising work inability if needed.
"We live in a capitalist society," he wrote. "I've found that the medical industry responds to these key words far more urgently than you describing unbearable pain and how it's impacting your quality of life."
However, his Reddit posts, did not contain direct criticism of health insurance industry profits. These sentiments apparently emerged later, as evidenced by a handwritten note discovered after his arrest for allegedly killing UnitedHealthcare CEO Brian Thompson.
The note mentions "parasites" within the healthcare system and criticises health insurers' influence and earnings, According to law enforcement officials. Upon his arrest in Pennsylvania, Mangione was heard shouting about an "insult to the intelligence of the American people" while being escorted into court by sheriff's deputies.
Meanwhile, a senior New York City police official confirmed on Thursday to NBC New York that there was no evidence of Mangione ever having UnitedHealthcare insurance.
Although the incident has led to questions about potential negative healthcare experiences, Mangione's 2023 post-surgery Reddit activity showed satisfaction with his treatment and relief from chronic pain. He advised others not to fear surgical complications and mentioned travelling to Asia for backpacking this year.
Interestingly, the 26-year-old Ivy League alumnus appears to have ceased social media activity approximately six months ago, coinciding with his loss of contact with family and friends.
Whilst his arrest has shocked his close circle, limited information exists about his recent physical and psychological wellbeing.
Meanwhile, healthcare professionals acknowledge the complexities of treating back pain.
"In the gross majority of treatments, surgery is when everything else has failed to provide relief," said Dr Jason Pittman, co-director of the Spine Centre at Boston's Beth Israel Deaconess Medical Centre. He said that doctors typically explore conservative treatments like physical therapy, injections or medications before considering surgery.
Despite having health insurance, patients may face substantial surgical costs depending on deductibles and other variables, although Mangione's financial situation remains unclear.
Dr Padma Gulur, a pain specialist at Duke Health, highlights that chronic back pain can substantially affect mental wellbeing.
“If you have underlying mental health issues — anxiety, depression — your pain can be worse because you have way more suffering. But, the second aspect is pain can push you into anxiety and depression,” said Gulur.
Additionally, details about Mangione's recent mental health remain unclear, though evidence suggests he was becoming increasingly isolated.
Police reports indicate that his family filed a missing person report in San Francisco in November. During his time at university, Mangione had shared his struggles with cognitive issues and sleep disturbances on Reddit.