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Eddie Howe was technically on firm footing as he rang the bell.

The Magpies manager had just set the 2023 Great North Run under way to loud cheers in the centre of the city.

But he had not accounted for those Sunderland-supporting runners who were less than pleased to see him as they sped past.

"The worst abuse I've ever had," he remarked this week. "I got verbally attacked by 50% of the people there."

This is far from an inter-city rivalry. These regional neighbours have won only one major domestic trophy between them in the past 50 years, and Sunday's game signals the first time they will meet in the Premier League for almost ten years.

But hardly any fixtures bring a region to a standstill quite like the Tyne-Wear derby as former Black Cats manager Peter Reid knows better than most.

"They're football crackers," he said. "Put it this way, there is a touch of extra needle up there."

A fixture like no other

Nikos Dabizas also knows what can happen when these forces collide.

A huge picture in the former Newcastle defender's home acts as a daily reminder.

It shows the Greek wild-eyed, shirtless and among his elated team-mates, after scoring the winner in front of the traveling support at the Stadium of Light in 2002.

This was a fixture that certainly made an impression on him.

"It's the intensity of the fans," he said. "This feeling that goes from generation to generation. This heritage makes this game so unique."

So what is at the core of the fierce rivalry between two football-mad towns less than 15 miles apart?

Well, as far as a Black Cats season ticket holder is concerned, it goes beyond football itself.

"You can trace it to the English Civil War with Newcastle siding with the monarchy and Sunderland backing the parliament," he said. "It's all political and economical tensions.

"Newcastle get the funding, Newcastle have the big city, Newcastle are the ones people always talk about when it comes to the North East. The other side are always shadowed."

But it is not at all one-sided.

A former player's father was even "mobbed" by joyous Newcastle supporters after his son scored a match-winning free-kick in a 1-0 victory at the Stadium of Light in 2011.

That is how much it mattered to the Geordies.

"It took a while afterwards to realise the significance of it," the player said.

"It made my life a lot easier. I was allowed to make the odd mistake when playing, simply because of that goal.

"Even now when I visit up to St James' Park and you've got dads telling their kids, 'See this lad? He scored the winner against our rivals'."

A derby win can even further elevate the standing of an already beloved figure.

A former Newcastle manager had not long delivered promotion back to the Premier League when he took charge of his first derby in 2010.

There may have only technically been three points at stake, but he quickly recognised the "extra weight" of this game because people in the North East "live for their football".

He said: "There are some derbies where you are unsure why they are derbies. This one, you do.

"These are two massive clubs - not far away from each other - with their own identities.

"Realistically, they are the two biggest games of the season so you are aware that the last thing you want to do is to lose, especially in your own stadium."

'The world will know the North East is back on the map'

That manager need not have worried.

His side ended up thrashing Sunderland 5-1 at St James' Park in 2010, but Newcastle have only won a single derby in the Premier League since then.

In fact, The Wearside club have triumphed in six of the last seven meetings in the top flight.

A former Sunderland manager oversaw half of those victories, having quickly realised that the fixture was "more significant" than many those from afar thought.

"After family, the club is the most vital thing to the people of Sunderland," he said.

"The passion is such that the result of the club can change the mood of the city so imagine the result of the derby? You can sense it.

"They told me on the first day. 'Please stay up, but you must beat Newcastle'. I remain unsure if it was more important to stay up or to beat Newcastle."

The club, like Newcastle before them, eventually succumbed to the drop in 2017, and spent eight years away from the top flight.

So a division separated these rivals when they last met in the FA Cup nearly two years ago.

And the difference was stark.

The combined cost of Sunderland's starting line-up that day was a mere fraction of the £40m Newcastle had spent on a single player.

The most experienced individual in the hosts' starting line-up was a clear margin ahead of others, at just 30 years of age.

"I don't think the fans really expected, deep down, that we were going to win that game," a former midfielder said. "But now it's different."

In numerous ways.

Only two players are likely to be the only holdovers from that 3-0 defeat in Sunday's lineup following the inspired arrivals of several new signings.

Sunderland also have a different manager, of course.

Not only has he led Sunderland to promotion - his fearless side have gone toe-to-toe with some the best teams in the top flight.

In fact, the reigning champions are the only team in the current top six to have beaten Sunderland this season, while his side are also undefeated on home soil.

Such an strong start to the campaign means Sunderland go into Sunday's game a point clear of Newcastle in the table.

So it is all set up to be a captivating afternoon when these rivals face off again at the Stadium of Light.

"On Sunday, the world will know the North East is back on the map with elite fixtures again," a former player added.