Symptom-wise, magnesium is often really helpful for twitching, as well as a lot of other symptoms (most - though not all) lyme doctors will recommend it.
Cause-wise, are you detoxing? Even some of the best MDs overlook how crucial this is. For whatever reason (there are plenty of possibilities) a lot of people can't detox the dead bacteria (along with all the other toxins we need to get out of our bodies regularly) as fast as we're killing them off with treatment, so we get what's known as a herx. There's more information about
that in the "new to lyme" thread - and plenty online as well.
You can look at it as a huge burden (which I have at times) or you can look at it as an opportunity, but it really is crucial to make healing your lifestyle while treating difficult lyme cases. Every little bit of toxic junk makes a difference. Of course you don't need to go overboard and be 100% rigid, but the more healthy lifestyle choices you can make, the better. Eat the organic food whenever you can, and change your version of junk into something healthier. Drink plenty of water, adding lemon helps. Do your research on the tons of detoxing ideas online and in books, etc. Sweat a lot! Whether it's through exercise, FIR sauna if you have access to one, or detox baths (there are recipes in the new to lyme thread that a lot of us here use a lot and love!). Dry skin brushing, teas, etc. The possibilities are endless!
I've never tried pinella, but samento (cat's claw) is one of my primary herbs that I'm treating with in pretty high doses, and while it hit me pretty hard at first, it's been really helpful!
Are you getting fevers along with the shivering? Or a low body temperature? It can be annoying, but also really helpful to monitor your temperature. In my experience, fevers mean slow down and rest, and low temperatures mean detox.