Do orthotics always work?

No, orthotics do not always work but that is somewhat subjective based on peoples expectations and what they wish the orthotics would do for them.  This is to say that unrealistic goals not shared with your doctor can lead to upsets as you may have as a standard that you will be able to run a marathon because of your new orthotics or that you can comfortably go hiking on mountain trails with zero discomfort or something of the sort.  In many instances these things are attainable but being in good communication with your doctor about your specific goals and expectations you have for your orthotics is very important for both your piece of mind and the overall result achieved with your orthotics. 
With that being said, the new style of Total Contact Orthotics your doctor uses is a revolutionary new design that we have found to work head and shoulders better than previous orthotic designs.  We have found this type of orthotic to work conservatively well over 90% of the time, based on testimonials and patient feed back.  More importantly, with this method we can often predict who it will work for before we even cast the patient for orthotics.  And to that end, although orthotics can be "miracle cures", if your particular instability is very severe, the orthotics in some cases can only offer partial relief as more aggressive treatment modalities such as bracing or ever surgery may be warranted. 
Being satisfied with your orthotics is in both yours and your doctors best interest so communicate exactly what you want to accomplish with your orthotics and he will be able to advise you if you can accomplish those things or not before you even get started.