This review proposes a modern, evidence-based framework for teaching and practicing manual therapy (MT), moving away from traditional principles such as clinician-centred assessment, patho-anatomical reasoning, and technique specificity. The new framework is grounded in three humanistic dimensions: safety, comfort, and efficiency, and is contextualized by positive communication, a collaborative environment, and person-centred care. It emphasizes best practices, reasoning, and communication, and is illustrated through two case studies. The paper discusses the clinical and cost-effectiveness of MT for musculoskeletal (MSK) conditions, supported by clinical trials showing benefits across various conditions. However, traditional MT principles are increasingly challenged by empirical evidence. The review highlights the limitations of traditional methods, including the over-reliance on imaging and specialized palpation, which may not be clinically valid or effective. The new framework promotes a person-centred approach, focusing on non-specific neuromodulation, communication, physical education, and contextual clinical effectiveness. It aligns with contemporary ideas of therapeutic alliance and holistic healthcare. The framework is simple to implement and is based on common healthcare principles, including safety, comfort, and efficiency. The framework emphasizes the importance of patient-centred assessments, such as thorough case histories and validated patient-reported outcomes. It also highlights the need for therapists to support patients' self-efficacy and empower them in their recovery. The therapeutic process should be efficient, aiming to achieve maximum benefit with minimal waste. The framework also emphasizes communication, context, and person-centred care. Communication is critical for shared decision-making and understanding the therapy's purpose. Context influences the therapeutic experience, and therapists should be culturally sensitive. Person-centred care involves respecting patients' values, preferences, and cultural backgrounds. The paper concludes that MT should include both passive and active interventions, delivered in a healing environment with a strong therapeutic alliance. The new framework is proposed for use in physiotherapy, osteopathy, chiropractic, and other manual therapy professions, aiming to improve outcomes through evidence-based, person-centred care.This review proposes a modern, evidence-based framework for teaching and practicing manual therapy (MT), moving away from traditional principles such as clinician-centred assessment, patho-anatomical reasoning, and technique specificity. The new framework is grounded in three humanistic dimensions: safety, comfort, and efficiency, and is contextualized by positive communication, a collaborative environment, and person-centred care. It emphasizes best practices, reasoning, and communication, and is illustrated through two case studies. The paper discusses the clinical and cost-effectiveness of MT for musculoskeletal (MSK) conditions, supported by clinical trials showing benefits across various conditions. However, traditional MT principles are increasingly challenged by empirical evidence. The review highlights the limitations of traditional methods, including the over-reliance on imaging and specialized palpation, which may not be clinically valid or effective. The new framework promotes a person-centred approach, focusing on non-specific neuromodulation, communication, physical education, and contextual clinical effectiveness. It aligns with contemporary ideas of therapeutic alliance and holistic healthcare. The framework is simple to implement and is based on common healthcare principles, including safety, comfort, and efficiency. The framework emphasizes the importance of patient-centred assessments, such as thorough case histories and validated patient-reported outcomes. It also highlights the need for therapists to support patients' self-efficacy and empower them in their recovery. The therapeutic process should be efficient, aiming to achieve maximum benefit with minimal waste. The framework also emphasizes communication, context, and person-centred care. Communication is critical for shared decision-making and understanding the therapy's purpose. Context influences the therapeutic experience, and therapists should be culturally sensitive. Person-centred care involves respecting patients' values, preferences, and cultural backgrounds. The paper concludes that MT should include both passive and active interventions, delivered in a healing environment with a strong therapeutic alliance. The new framework is proposed for use in physiotherapy, osteopathy, chiropractic, and other manual therapy professions, aiming to improve outcomes through evidence-based, person-centred care.