Chronic non-specific low back pain is a common and disabling condition that places a significant burden on individuals and healthcare systems worldwide. Manual therapy and exercise therapy are widely used conservative treatment approaches; however, uncertainty remains regarding their relative effectiveness and the value of combining these interventions in routine clinical practice. This narrative review aimed to synthesize current evidence comparing manual therapy and exercise therapy when used as stand-alone treatments and to explore the potential benefits of combined approaches within a person-centred care framework. A comprehensive search of major biomedical databases was undertaken, including PubMed/MEDLINE, Embase, the Cochrane Library, and Web of Science. Randomized controlled trials, systematic reviews, meta-analyses, and relevant clinical practice guidelines involving adults with chronic non-specific low back pain were considered. Evidence was synthesized qualitatively, with attention to pain, disability, functional outcomes, quality of life, and patient satisfaction. The findings indicate that both exercise therapy and manual therapy provide modest but statistically significant improvements in pain and function compared with minimal or usual care. Exercise therapy demonstrated more consistent long-term benefits for disability and functional outcomes, while manual therapy was primarily associated with short-term pain relief. Direct comparisons between the two approaches showed no clear superiority of either intervention. Combined manual therapy and exercise programs resulted in slightly greater short-term pain reduction and higher patient satisfaction, although long-term outcomes were largely driven by continued exercise and self-management. Overall, the evidence supports exercise therapy as the foundation of management for chronic non-specific low back pain, with manual therapy serving as a useful adjunct for short-term symptom relief. A multimodal, person-centred approach that emphasizes active participation and long-term self-management appears most appropriate for optimizing clinical outcomes.