Swelling and pain in the big toe may be caused by non-disease factors, such as inappropriate shoes, which do not require treatment and can be replaced by loose shoes; however, it may also be caused by disease factors, such as gouty arthritis, bunions and other diseases, which can be treated with general, medication and surgery as prescribed by the doctor. 1. Non-disease factors: Wearing inappropriate shoes, big toes may become swollen and painful due to extrusion and excessive friction. Usually, no treatment is needed, and it is recommended to wear loose and comfortable shoes. 2. Disease factors (1) Gouty arthritis: Most patients first develop the problem in the big toe, followed by the instep, ankle, fingers, wrist and other parts of the foot, and the affected area may become red, swollen, hot and painful. Diet should be controlled by abstaining from high-purine foods, such as animal offal and oysters, and increasing the amount of water intake to facilitate urate excretion and weight control. During the acute attack period, colchicine, ibuprofen, prednisone, etc. can be used as prescribed by the doctor to alleviate the symptoms. In addition, probenecid, allopurinol, etc. can also be used as prescribed by the doctor to promote the excretion of uric acid or to inhibit the production of uric acid. (2) Bunion: The first metatarsophalangeal joint of the bunion is excessively deviated to the lateral side, accompanied by redness, swelling, pain and other discomforts of the joint. Loose or open-toed shoes should be worn to avoid aggravating the discomfort. If the condition is serious, surgical treatments such as soft-tissue surgery or osteotomy and orthopedic surgery can be performed as prescribed by the doctor. In addition, there are many other reasons that can cause swelling and pain in the big toe, such as onychomycosis, if the pain is not relieved, it is recommended to consult a doctor in a timely manner to identify the cause of the disease, and then follow the doctor’s instructions for treatment.