Numerous conditions can cause bilateral lower leg pain. Photo Credit legs image by Leticia Wilson from Fotolia.com. Bilateral lower leg pain is pain in both legs, anywhere between the knees and the ankles. According to MayoClinic.com, leg pain can manifest anywhere from the hips to the ankles, and it may be caused by structures or tissues in other parts of the body, such as the lower back or feet. The lower leg is the area between the knees and the ankles.