Waking up in the middle of the night with back pain and no pain during the day is a condition that has a very, very low chance of being cancerous. First, one must consider whether there is some muscle strain in the back or it is caused by inflammation of the fascia of the back. Usually, there is a very obvious pressure point of the muscle in the back. When moving the back or bending over or lowering the head, it will induce its pain. Second, you can observe whether there is pressure pain in the middle of the thoracic spine and spine. If there is pressure pain, and if it is accompanied by pain when moving the thoracic spine, it may be caused by misalignment of the small joints of the thoracic spine. Then, you can also take a chest X-ray or chest CT to rule out whether there is a tumor in the chest cavity or an abnormal lesion that causes back pain.