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Is your dog suddenly fearful of noises that were never a problem before? A new study suggests that before you look for a behavioral solution, you should make sure there isn’t an underlying medical cause.

The study, which was published in February 2018 in, looked at two groups of dogs that were brought to a clinical animal behaviorist because of fear or anxiety triggered by sound. One group was also diagnosed as having some type of musculoskeletal pain, such as or a degenerative joint condition. The other, the control group, didn’t suffer from any painful problems.

The physical signs of fear were the same in both groups, mostly consisting of shaking, trembling, and hiding. However, significant differences were also found. Dogs that had pain tended to become more broadly fearful — along with being afraid of places where they had heard loud noises, they generalized the fear to new situations, people, and dogs.

The researchers hypothesize that when a dog suffering from pain gets startled or tenses up from a loud or sudden noise, it aggravates their pain. This causes a learned association between loud sounds and pain to develop, which can easily generalize to all kinds of situations where the dog has experienced noise. Chronic pain can also affect a dog’s social interactions, and a quick or aggressive movement to avoid an encounter with an approaching dog may hurt, so an association between other dogs and pain is learned as well. It should be noted that dogs don’t “understand” pain. They do not comprehend why their life is different than it was before, hence the anxiety and shivering associated with pain.

The dogs diagnosed with pain also developed their fear of noise later in life than the control group. The average age that their fear of noise started was around four years older than the dogs who didn’t have pain issues. Therefore, if dogs develop this fear later in life, they should have a thorough medical exam before any attempt to address the behavioral problem.

The good news is that once the underlying physical problems are correctly identified, they can be treated. Dogs in the pain group were given treatment plans that included pain medication and management advice to avoid aggravating the pain. All dogs in both groups were given behavioral modification plans involving counterconditioning and/or desensitization to sounds, and most were also given anti-anxiety medication. While it’s possible that treating the pain alone might have helped, it’s likely that the learned associations and fear of noise would have persisted. For the sake of the dogs, the option of only addressing their pain wasn’t tested. The majority of the cases in both groups were improved to the owner’s satisfaction by the time of publication.