Does offering it up mean refusing pain relief?

No. Offering it up refers to uniting suffering you already have with Christ's, so that something otherwise meaningless can carry meaning. It is a way of interpreting suffering, not an instruction to acquire more of it.

The Vatican's 1980 declaration on euthanasia acknowledges that some Christians choose to moderate their use of painkillers, and then draws the line explicitly: "it would be imprudent to impose a heroic way of acting as a general rule. On the contrary, human and Christian prudence suggest for the majority of sick people the use of medicines capable of alleviating or suppressing pain."

It goes further on behalf of patients who cannot speak, saying one may reasonably presume that they wish to take painkillers and have them administered according to the doctor's advice.

John Paul II restated it in 1995, saying that while praise may be due to a person who voluntarily forgoes painkillers to remain lucid, "such heroic behaviour cannot be considered the duty of everyone."

The seventh edition of the US bishops' directives, approved in November 2025, added a phrase describing how spiritual support should be offered: "while not valorizing pain and suffering."