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Выделяют две основные формы [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/): \n1. **Латеральный (наружный)** — поражение сухожилий, крепящихся к внешнему надмыщелку [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). Боль возникает при разгибании кисти, захвате предметов [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n2. **Медиальный (внутренний)** — воспаление сухожилий внутреннего надмыщелка [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). Болезненные ощущения становятся более выраженными при сгибании запястья [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n\nВ зарубежной литературе латеральную форму часто называют «локоть теннисиста», а медиальную — «локоть гольфиста» [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/).\n\n## Причины\nОсновная причина — **повторяющиеся микротравмы сухожилий** из-за чрезмерной нагрузки на мышцы-разгибатели или сгибатели запястья [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). Некоторые провоцирующие факторы: \n* профессиональная деятельность, связанная с монотонными движениями (маляры, программисты, швеи) [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/); \n* спортивные нагрузки (теннис, гольф, тяжёлая атлетика) [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/); \n* бытовое перенапряжение (ношение тяжестей, ремонтные работы) [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n\nВоспалительный процесс развивается постепенно: постоянные микроразрывы сухожилий приводят к их дегенерации, замещению нормальной ткани рубцовой [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/).\n\n## Симптомы\nКлиническая картина зависит от формы эпикондилита [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/): \n* **Латеральный** — боль по наружной стороне локтя, усиление дискомфорта при разгибании пальцев, повороте ладони вверх [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). Слабость в кисти (трудно удержать чашку, открыть дверь) [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n* **Медиальный** — ноющая боль во внутренней части сустава, усиление симптомов при сгибании запястья [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). Ощущение скованности в локте [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n\nВ обоих случаях в покое боль стихает, но возвращается при нагрузке [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/).\n\n## Диагностика\nДиагноз ставится на основе [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/): \n* **Осмотра** — пальпация выявляет болезненность в зоне надмыщелка [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n* **Функциональных тестов** — пробы на сопротивление движению кисти [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n* **Инструментальных методов** (редко, для исключения артрита, туннельного синдрома) — УЗИ мягких тканей, МРТ (при подозрении на разрыв сухожилий) [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). Рентген неинформативен при эпикондилите локтевого сустава, так как изменения затрагивают только мягкие ткани [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/).\n\n## Лечение\nЛечение направлено на устранение боли, снятие воспаления и восстановление повреждённых тканей [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). В большинстве случаев оперативное вмешательство не требуется, но при хронических формах с выраженным болевым синдромом и ограничением функции сустава могут применяться хирургические методы [1](https://BestClinic.ru/diseases/epikondilit-loktevogo-sustava/). \n\n**Обратиться к врачу** необходимо при первых симптомах боли или дискомфорта в области локтевого сустава [2](https://lit-clinic.ru/diseases/epikondilit-loktevogo-sustava/). 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