Acupuncture vs. acupressure: which eases MS bladder woes?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Female patients, aged 18-60 years, with relapsing-remitting multiple sclerosis (RRMS) and an Expanded Disability Status Scale (EDSS) score ≤ 6 * Stable immunomodulatory MS therapy for at least 3 months prior to enrollment * Presence of at least 3 out of the following 6 criteria indicative of overactive bladder dysfunction: urgency, daytime urinary frequency \>10 times, nocturia \>1 time per night, post-void dribbling, incontinence, or delayed initiation of micturition * Participants must be willing and cognitively and linguistically capable of adhering to the study protocol, performing the study interventions, and completing the required study documentation * Capacity to provide informed consent, and provision of written consent for both written and electronic data collection and participation in the study Exclusion Criteria: * Acute MS relapse within the last 3 months prior to individual study entry * Planned change in immunomodulatory therapy during the study period * Current need for regular self-catheterization (more than twice per week) * Clinically relevant post-void residual volume, confirmed by ultrasound (\>100 mL or \>40% of pre-void volume) * Current or past history of bladder cancer * Implanted defibrillator or other pacemaker * Urogenital causes of bladder dysfunction, such as stress urinary incontinence or bladder prolapse * Spinal trauma within 5 years prior to study entry or any other pre-existing central nervous system disorders (e.g., stroke, Parkinson's disease), or history of pelvic, spinal, or bladder surgery * Acute urinary tract infection at the time of screening or within the previous 4 weeks * Urolithiasis or urogenital tumors within the past 6 months * Previous electrical posterior tibial nerve stimulation (TNS), acupuncture, or acupressure in the same anatomical region within 3 months prior to study entry * Regular pelvic floor training (more than twice per week) in the past 6 weeks or planned during the study period * Planned participation in another interventional clinical trial during the study period * Open wounds, edema, or lymphedema in the lower leg that may interfere with local intervention * Other serious pre-existing conditions (e.g., active cancer, heart failure, epilepsy, etc.) that contraindicate participation in the study * Obesity, defined as BMI \> 30 * Pregnancy or breastfeeding