Thanks for asking at Healthcare magic. I read your question and I understand your concern. There are two possibilities for pain, swelling big toe joint. 1. tight shoes 2. Podagra.. an acute attack of Gout I would like to advise you to wear loose shoes. Take pain killers like Advil with two glasses of water. apply cold packs. If the pain still persists then it s acute attack of gout due to increase uric acid level in blood either due to over production or its underexcretion. You have to be investigated for digging out the cause. Do synovial fluid analysis in which needle like crystals with negative birefringance under polarized light are diagnostic of gout, do serum uric acid level, Peripheral smear to ruled out increase cell turnover. For acute attack NSAIDs like advil, steroids even Intra articular if NSAIDs does not help or if these two are contraindicated like in peptic ulcer then cholchicine. For chronic prevention there are two things. 1. drugs like Allupurinol, Febuxostat 2. life style modification.. lose weight if obese, limit alcohol consumption, take low fat and low meat diet. take vitamin C as it helps in decreasing uric acid level in blood. Hope it helps best. Don t forget to rate this answer and close the discussion at Healthcare magic. Take your best care. Regards Dr Ejaz