Hi DHCKris, I just saw this thread now, and your symptoms seem very similar to what I have been going through for almost two years. Although I do have moderate ongoing pain in my feet in addition to the twitching/cramping, and numb toes. My symptoms came on fairly quickly - over a period of about 6 months, but then stabilized and hasn't changed much in over a year now.

One thing I have discussed before is that there seems to be a large overlap between BFS and SFN (you can find studies supporting this if you google it). (There is also a large overlap between fibromyalgia and SFN.) Unfortunately, knowing there is this link hasn't lead to any understanding of why the link exists - nor has it lead to any breakthroughs in treatment options.

In my case, the cramping got quite bad early on. In particular, the shin area of my right leg would cramp badly while driving - obviously making it very difficult. Neurologist put me on gabapentin, which greatly relieved the twitching and cramping symptoms. I'm not a fan of some of the side effects, but overall the reduced cramping and the pain reduction I'm getting outweigh the side effects.