Olive leaf extract is also known to have antiviral, antibacterial and antifungal properties. It is a salicylate, similar to aspirin so it may not agree with some individuals.

It also has good anti-oxidant properties and is a vasodilator (opens up blood vessels) so may be helpful in other aspects of arachnoiditis such as poor circulation.

Dr Mosharaf Ali runs an Integrated Health Clinic in London. He suggests the following holistic measures for the fatigue experienced in Chronic Fatigue Syndrome:

• a regime of diet, exercises and massage  (Regimen Therapy). This is not necessarily strenuous activity, which is not feasible, but gentle exercise;
• specialized therapies such as massage, in particular, Ayurvedic oil, specific back and neck exercises (to improve circulation), nutritional medicine (notably vitamin B12, and C, as well as calcium, magnesium and selenium) to boost energy,  acupuncture.   
  

Other medications

Amantadine is prescribed for fatigue associated with MS as a first line treatment. It is also an antiviral agent that acts on the dopamine system, taken at 100mg twice a day. Side effects tend to be mild, but prolonged treatment may become ineffective.

Provigil (Modafanil) is another drug used in severe cases of fatigue in conditions such as MS.

However, it must be used under informed supervision when you are already taking a cocktail of drugs for pain, etc as a result of arachnoiditis.

Recent research has found that Provigil taken 200mg a day has shown benefit in combating MS-related fatigue when assessed using a scale called the Modified Fatigue Impact Scale. (Pemoline, a further option, was investigated in 2 clinical trials but failed to show a significant benefit over placebo.)

As the Bandolier review suggests, there is in fact a shortage of in-depth research into the effects of medication on fatigue even in conditions such as MS, in which fatigue is so well recognised.

The closing comment:

"There are times when saying that more research is needed shames us all" speaks volumes.