This sounds similar to Charlie horses maybe. I get cramps and spastic muscles all the time, and yes, twitching.

I just saw my neuro yesterday. I have small fiber neuropathy only, and he said these symptoms are very common in small fiber neuropathy, because the tiny sensory nerves misfiring irritate the surrounding tissues.

He also said that without even realizing it, I am probably just more tense in my muscles due to increased pain and discomfort, and this consistent but low-end tension can lead to things like cramping and twitching, since you're never truly very relaxed.

Cramping and twitching is also very common with stress and increased anxiety, and mine, even though it is always there daily even if on a lower level, is much worse when I am really stressed, really anxious, or really tired.

Just some stuff to think about.