Luigi Mangione, the man charged with murdering Brian Thompson in New York City, reportedly suffered from severe back pain, prompting him to undergo surgery last year, his friend said.

His back pain was chronic and an ongoing problem for the defendant, said RJ Martin, a friend of Mangione and a spokesman for Surfbreak, a Honolulu condominium where Mangione lived for about six months The New York Times.

Martin told the newspaper that Mangione moved to Hawaii in hopes of getting as healthy as possible before major back surgery.

The injury kept Mangione from surfing and affected his romantic life, the spokesman said.

“His spine was kind of misaligned,” Martin said The times. “He said his lower vertebrae were almost half a centimeter apart and I think it pinched a nerve. Sometimes he was fine, sometimes he wasn’t.”

Martin said Mangione eventually underwent spinal surgery in 2023.

Mangione sent him a photo of his X-ray, which “looked hideous, with just huge screws in his spine,” Martin told CNN.

Luigi Mangione, 26, was seen eating at a McDonald’s in Altoona, Pennsylvania, Monday morning and a witness reported him to police. That set off a whirlwind of investigations that culminated in him being charged with murder in New York and murder in Pennsylvania.

He is currently being held without bail in a Pennsylvania prison.

Here’s what you need to know:

The Mangione family spoke out Monday about allegations that Luigi Mangione fatally shot UnitedHealthcare CEO Brian Thompson in Manhattan last week.

In a statement from Maryland House of Representatives member Nino Mangione, the family expressed shock and said they were praying for Thompson’s family.

In addition to five state charges in Pennsylvania, Luigi Mangione now faces another string of felony charges in New York, where he is accused of fatally shooting United Healthcare CEO Brian Thompson last week.

Those who knew Luigi Mangione and his prominent Baltimore-area family are stunned that the 26-year-old has been charged with the murder of UnitedHealthcare CEO Brian Thompson.

Mangione attended an elite private school and then completed an Ivy League education. He comes from a family where real estate success, charity and local politics play a major role.

The 26-year-old was “just the last person you would suspect,” said Thomas J. Maronick Jr., a lawyer and radio host who knows several members of the Mangione family The New York Times.

“It’s just such a well-respected family and such a prominent family in Baltimore County,” he said.

The shocking shooting of UnitedHealthcare CEO Brian Thompson last week in New York City is something of a static anomaly.

New York prosecutors have charged Luigi Mangione with first-degree murder.

According to ABC News, the charges in New York were filed hours after he was charged with gun crimes in Pennsylvania. Magione was arrested Monday in Altoona, Pennsylvania.

Online retailer Amazon has removed merchandise that purportedly celebrates the fatal shooting of UnitedHealthcare CEO Brian Thompson.

Dealers briefly listed T-shirts and sweatshirts with the slogan “Defy / Defend / Depose,” a reference to words on ammunition casings found near the shooting site.

The company withdrew such products soon after, The Washington Post Reports.

The Mangione family has spoken out following Monday’s arrest of Luigi Mangione, who is believed to be involved in the fatal shooting of UnitedHealthcare CEO Brian Thompson.

Read her full remarks below, courtesy of NewsNation correspondent Brian Entin.