The Patch does break down for some people after 48 hours. When I was using it I was using the 50s and down to 36 hours of use. Finally I just ripped the last one off and decided to not use it again.
I have been through all the drugs you have mentioned. The only thing that helped my leg pain is burning the nerve that is causing the pain. Then again I have Joint Facet problems in the L3-L5 area and they are pinching or impinging the nerves and causing my sciatica. The results last about 6 months for me and then I have to do it again.
The process is called Radio Frequency Ablation if you want to look it up.
Good luck with finding help with your nerve pain.
Have you seen a pain doc yet?