Boston Mayor Thomas M. Menino suffered another setback and will remain hospitalized indefinitely as doctors try to determine what caused a fresh surge of pain in his ailing back.

Speaking today at a press conference, two of Menino’s physicians said they could not give any estimate when the mayor might be released from Brigham and Women’s Hospital, where he was admitted almost three weeks ago with a viral infection and a blood clot.

Boston, MA 101312 Mayor Thomas M. Menino (cq), right, strategized with local union leaders on how to elect US Senate nominee, Elizabeth Warren (cq), during a meeting in Dorchester, Saturday, October 13 2012. Daniel Ottaviano (cq), left of Mayor, of Local 22 laborers was among those in attendance. (Globe Staff Photo/Wendy Maeda) section: Metro slug: 14menino reporter: Maria Cramer
The mayor at a recent meeting with union leaders on election strategy (Wendy Maeda/Globe Staff)
The Boston Globe

“He was getting better, then recently more pain — and that has been responsible for the holdup” Dr. Dale Adler told a throng reporters and video cameras, adding, “All the other problems are taken care of. Now the focus is why his back is hurting him more. There are a plethora of theories, and that’s what we’re going to work on.”

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Menino, 69, has not set foot in City Hall for a month. He left on Oct. 14 for what was supposed to be a two-week trip to Italy with his wife for their 46th anniversary. Feeling ill on a cruise, Menino cut the trip short, returned to Boston, and sought medical care on Oct. 26.

Over the last few weeks, Menino has continued to run the city from his hospital bed, according to his press secretary, Dot Joyce. At least twice a day, aides have shuttled documents from the City Hall to the hospital, Joyce said, bringing Menino briefing memos to read, labor contracts to sign, and a City Council redistricting ordinance to approve.

While Menino was in Italy, City Council President Stephen J. Murphy took over a few of his duties, signing documents so money could be dispersed to pay the city’s bills. The temporary transfer of power is outlined in the city charter, which stipulates that City Council president in becomes acting mayor when the Boston’s chief executive is absent from the city. Since Menino’s return to Boston, the mayor has been in full control.

“He’s been running the city,” Murphy said today. “He’s got a good team. When I talked to him last week, he sounded like he had his fastball.”

Joyce said at the news conference that Menino had no intention of transferring power to Murphy while he remained hospitalized.

“At this point, the mayor is fully engaged,” Joyce said. “There is no need. If there is a point, we can discuss it.”