Pain and swelling in the smallest toe after an injury can happen due to soft tissue strain, ligament injury, bruising, nail injury, or sometimes a small fracture. Mild injuries usually improve gradually with rest and proper care, but significant swelling, difficulty walking or severe pain may require clinical assessment to rule out a fracture or deeper injury. Resting the foot, avoiding pressure on the injured toe, and keeping the foot slightly elevated may help reduce swelling. Applying a cold compress for short periods during the first couple of days may also help reduce pain and inflammation. Wearing comfortable open footwear and avoiding excessive walking may prevent further irritation while the toe heals. Antibiotics are not always needed, unless there is an open wound, pus, redness spreading around the toe or signs of infection. Pain medicines may help, but treatment depends on the severity of the injury and your overall health. Consult a doctor if swelling becomes severe, walking becomes very difficult, the toe looks deformed, numbness develops, or the pain continues to worsen despite rest and appropriate care.