Isn't the jerks how this all began?

I'm confused at this point. You've stated that this began (even with medications) over a year ago with twitches and jerks and that you've been through 4 neuros. Can't the jerks just be progression if you've already had them for so long? How do you know (or think) they are the nortriptyline?

I'd stop making changes to your medication until the doctor gives advise. Your body doesn't have a chance to figure out what it's supposed to do with what you're giving it. Your best bet for pain relief will be the combo of gabapentin and nortriptyline and hopefully your doctor will tell you the appropriate doses of each. I think you said this is your PCP, not neuro. I hope he's comfortable addressing this for you without just sending you on to another neuro and wasting more time for you.