Common stuff that comes up:
-tolerance builds faster than expected (even intrathecal)
-catheter placement isn’t ideal, so the drug isn’t hitting the right level
-opioids alone don’t work well if there’s a neuropathic component (butt/feet pain especially)
-people sometimes only improve after adding another med (clonidine, bupivacaine) or switching to something like ziconotide
Also that “94% success rate” is pretty optimistic vs real-world results, especially with long-term injuries.
If your trial was a bolus and now you’re on continuous infusion, that could explain a lot too.
Honestly, you’re doing the right thing pushing for adjustments—I'd definitely ask about combo therapy and possibly checking catheter placement at your next visit.