Pain in the big toe may be caused by gouty arthritis. Patients suffering from gouty arthritis may have elevated blood uric acid levels due to abnormal purine metabolism, which can cause gouty arthritis if they consume too much purine-rich foods in their diet, such as seafood. Patients may experience pain in the toe with symptoms such as redness and swelling of the toe joint, often occurring suddenly at night. Pain in the big toe may also be caused by nail fungus. As a result of the patient being infected by nail fungus bacteria, the toe appears red, swollen, hot and painful. Trauma may also cause the symptoms of toe pain. When toe pain occurs, the first thing to do is to take rest, and anti-inflammatory and analgesic drugs are needed to relieve the pain. If you are suffering from gouty arthritis, you should apply antipyretic and analgesic drugs in addition to uric acid-lowering drugs. Toe pain caused by nail infection needs to be treated with antibiotics for anti-infection.