Pain in the ball of the foot below the big toe is not necessarily gout, but may also be other diseases, as follows: 1, the first metatarsal toe osteoarthritis: the first metatarsal toe joint is prone to degenerative changes in the case of long-term excessive weight bearing, the patient will have significant pain in the ball of the foot below the big toe, accompanied by swelling and limited activity. X-rays will reveal severe osteophytes, joint space narrowing, and even joint asymmetry in the first metatarsal toe joint; 2. Gouty arthritis: easily deposited in the big toe joint, causing painful symptoms in the toe joint palm, accompanied by local redness, swelling, and activity limitation, and a significant increase in serum uric acid; 3. Trauma: local sprains can also cause pain in the palm below the big toe, accompanied by local activity limitation and swelling. Patients usually have a clear history of trauma, and pain symptoms can be significantly relieved with cold compresses, braking, and rest.