Luigi Mangione, Assassin of the UnitedHealthcare CEO, Suffered From Chronic Low Back Pain
PA Department of Corrections
On December 4th, 2024, Luigi Mangione shot and killed UnitedHealthcare (UHC) CEO Brian Thompson. While many on social media rail against insurance companies denying claims, that doesn’t appear to be why Mangione carried out the murder. His exact motives beyond anger at the health care industry writ large are not currently known.
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Luigi Mangione suffered from spondylolisthesis, which involves one vertebra shifted forward relative to another. Because the nerves exit the spine through holes made between the vertebrae, called foramina, this can result in pinched nerves and debilitating pain. He then underwent a spinal fusion surgery for the condition. I think it’s safe to say he wasn’t thrilled with his health care and how he felt after surgery. I don’t know the details of his condition and can’t comment on whether or not spinal fusion surgery was right for him.​​​​​​​​​​​​​​​
Via Physiopedia
Spinal surgery may be the right option for some people, but spinal surgeries often don’t have great results. Why? There are a number of reasons. First, surgery itself is a serious procedure. There will be scar tissue, the possibility of human error, etc. Also, if you don’t fix the mechanisms that caused the condition, it’s possible the next segment will degrade unless habits are changed. Furthermore, even if surgery improves your condition, that doesn’t mean there were no non-surgical options that could have had the same or greater benefit.
Dr. Stuart McGill is one of the foremost experts on back pain. He has written a few books, including Back Mechanic, which is a great book for laypeople to understand their back pain and use as a guide for getting out of pain and one that I’ve recommended to clients. Dr. McGill believes that spinal surgery should be an absolute last resort. In the embedded video below, McGill says, “If the person was told 'you’ve tried physio, chiro...you’ve tried it all and you’ve failed. The last hope for you is surgery.' So, if that’s the category that they came to us under, I can tell you that after doing the program in Back Mechanic, in a 2-year follow-up...95% of them avoided surgery and were glad that they did.”
It’s been reported that Luigi Mangione’s back pain severely impacted his life. He took a surf lesson in Hawaii but was then bed-ridden for a week with back pain. He wasn’t in a relationship because “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.”
I can’t sympathize with Mangione on taking out his anger on the UHC CEO, but I can sympathize with his frustration over his back pain. I’ve also had episodes of trying some activity and suffering for it, including sex. I’ve foregone some excursions because of fear over how my back would feel. When I was living in South Korea, I wanted to go horseback riding in the countryside of Mongolia. A major reason it never happened was that I was worried about how I’d feel bouncing on a horse for hours on end. I’d have been far from anywhere I could have gotten therapy if needed. What if I was in the middle of nowhere laid up in a yurt for days?
Back pain can be crippling, and it’s incredibly widespread. In 2019, the CDC found that 39% of U.S. adults had back pain in the past 3 months! When you factor in health care, disability programs, the loss of economic production due to people who are out of the labor force or miss work because of pain, it costs us hundreds of billions of dollars. It’s frustrating that there aren’t more programs, awareness, insurance coverage, urban design, and so on in order to help people live healthier and more fully. Interventions like Rolfing would save society money, time, and health in the long-run and I hope we move towards making it easier for people to learn about and engage in healthy practices.