Conditions that commonly cause pain in the big toe joint include bunions, arthritis and gout.  All of these conditions, when painful, require anti inflammatories to calm the painful area down.  In addition, these conditions seem to be worse with certain shoes and activities.  If pain is due to a bunion or arthritis, icing, wearing shoes with a roomy toe box and rest from activities that aggravate the pain are a good place to start.  In instances where gout is the cause of pain, typically the joint is too painful to even wear a sock or cover with sheets while sleeping.  In this case, the inflammation will calm down as the gout attack comes to an end, but without treatment this can take up to a week to feel relief.  If your pain fails to improve with these at-home treatments, call and make an appointment to see your podiatrist for further evaluation.