Untangling the Osteopathic Gordian Knot: Reconceptualized Principles for Sustainable and Contemporary Clinical Practice—A Conceptual Perspective

Background: Osteopathy's integration into contemporary healthcare requires clear articulation of its theoretical and practical foundations and active engagement in interprofessional practice. Despite growing institutional recognition, conceptual ambiguity remains regarding foundational principles and their operationalization. Osteopathy is broadly described as a person-centered, evidence-informed discipline promoting health through manual and educational strategies within systemic and biopsychosocial contexts. Objectives: This Perspective critically examines osteopathic principles, proposes a shared conceptual model for interdisciplinary care, and outlines a structured research agenda for empirical validation, aiming to enhance person-centered, preventive, and sustainable practice. Methods: A narrative review synthesized historical, theoretical, and contemporary evidence. Records were thematically analyzed through expert collaborative brainstorming to achieve consensus, ensuring both conceptual and empirical rigor. Results: Twenty-two studies were included, forming two thematic areas: (1) historical evolution of osteopathic principles, encompassing foundational definitions, early interpretive divergences, codifications, and adaptations; and (2) contemporary reconceptualization for interdisciplinary care, integrating systems-oriented and biopsychosocial frameworks. Emphasis was placed on self-regulation, structure-function relationships, and holistic care. This synthesis bridges historical and modern insights, highlighting osteopathy's relevance in integrative, pediatric, and preventive healthcare. Conclusions: Reconceptualizing osteopathic principles strengthens professional identity and supports sustainable, evidence-informed, person-centered practice. The proposed framework informs interprofessional collaboration and guides a research roadmap to validate and integrate osteopathy globally within contemporary healthcare systems.