There are a number of medicinal herbs such as horse chestnut seed, butchers broom and pycnogenol, which research has found to be a safe and effective treatments for chronic venous insufficiency(CVI).
Chronic venous insufficiency refers to functional abnormalities of the venous system and venous disorders can cause a number of symptoms such as oedema, ankle swelling, varicose veins, leg ulcers and skin changes(hyperpigmentation).
Venotonics, also known as venotropics or phlebotropics, are a class of herbs/drugs that have an effect on the venous system and veins, typically used to treat venous disorders such as venous insufficiency.
Many herbs have proven venotonic properties including butchers broom, horse chestnut seed and the dietary supplement pycnogenol.
Some of my other favorite herbs for supporting the cardiovascular system and circulation include coleus forskohlii, garlic, ginkgo biloba, green tea, hawthorn, prickly ash bark and many others.
Cardiovascular and circulatory disorders is another area where herbal medicine excels and various botanicals can be used to strengthen and tone the blood vessels, enhance deep circulation and to address the likes of inflammation, oxidative stress and endothelial dysfunction, all factors which play a role in the pathophysiology of chronic venous diseases.
We are going to look at three evidence-based natural remedies below for the treatment of chronic venous insufficiency and related venous disorders.
Pycnogenol is a French maritime pine bark extract produced from the outer bark of Pinus pinaster Ait. subsp. atlantica.
Pycnogenol has strong antioxidant, anti-inflammatory and vasodilator activities, antithrombotic effects and collagen stabilizing properties make it uniquely able to target the multi facet pathophysiology of CVI and related venous disorders.
Clinical studies have shown that it can reduce oedema of the legs in CVI, reduce the incidence of deep venous thrombosis during long haul flights and enhance the healing of venous ulcers and haemorrhoidal episodes by topical application and/or oral administration. 
Butcher’s broom helps to dilate the major blood vessels in the legs.
Research has also confirmed that Butchers Broom has proven phlebotherapeutic properties, including vasoconstrictive action and venotonic properties, making it an excellent choice of herb for treating venous insufficiency.
A multi-center, double-blind, randomized, placebo-controlled trial published in 2002 confirmed the efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency.
The study concluded:
Considering the study duration of three months it is concluded, that ruscus extract, in the recommended daily dosage according to the German monograph, is a safe and effective treatment for patients suffering from chronic venous insufficiency. 
Horse Chestnut Seed
Horse chestnut seed extract is another popular evidence-based medicinal herb for treating chronic venous insufficiency.
The latest 2012 update of the Cochrane review first published in 2002 concluded:
The evidence presented suggests that HCSE is an efficacious and safe short-term treatment for CVI.
However, several caveats exist and larger, definitive RCTs are required to confirm the efficacy of this treatment option.
Overall, there appeared to be an improvement in CVI related signs and symptoms with HCSE compared with placebo.
Leg pain was assessed in seven placebo-controlled trials. Six reported a significant reduction of leg pain in the HCSE groups compared with the placebo groups, while another reported a statistically significant improvement compared with baseline.
One trial suggested a weighted mean difference (WMD) of 42.4 mm (95% confidence interval (CI) 34.9 to 49.9) measured on a 100 mm visual analogue scale.
Leg volume was assessed in seven placebo-controlled trials. Six trials (n = 502) suggested a WMD of 32.1ml (95% CI 13.49 to 50.72) in favour of HCSE compared with placebo.
One trial indicated that Horse Chestnut Seed Extract may be as effective as treatment with compression stockings.
Adverse events were usually mild and infrequent. 
 Pycnogenol® in chronic venous insufficiency and related venous disorders.
 Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency.
 [Butcher’s Broom, in the treatment of venous insufficiency].
 Horse chestnut seed extract for chronic venous insufficiency.
The information in this article has not been evaluated by the FDA and should not be used to diagnose, cure or treat any disease, implied or otherwise.