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

The Magpies manager had just got the 2023 Great North Run started to rapturous applause in the heart of the city.

But he had not accounted for those Sunderland-supporting runners who were not so thrilled to see him as they whizzed past.

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

This is far from an ordinary rivalry. These North East 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 top division for nearly a decade.

But hardly any fixtures halt an area quite like the Tyne-Wear derby as former Sunderland manager Peter Reid understands 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

A former Newcastle defender also knows what can happen when these forces collide.

A huge framed photograph in the former Newcastle centre-back's home serves as a daily reminder.

It captures the Greek wild-eyed, bare chested and among his jubilant team-mates, after scoring the winner in front of the away fans at the Stadium of Light in 2002.

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

"It's the intensity of the fans," he said. "It's something that goes from father to son. This heritage makes this game so special."

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 transcends 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 rooted in historical and economical factors.

"Newcastle receive the investment, 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 overshadowed."

But it is not at all one-sided.

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

That is how much it mattered to the Geordies.

"I needed a while afterwards to realise the importance of it," the player said.

"It made my life a lot simpler. I was forgiven to make the odd mistake when playing, purely because of that goal.

"I still go 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 boost the standing of an already popular 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 "added responsibility" of this game because people in the North East "breathe their football".

He said: "There are some derbies where you are not quite sure why they are derbies. This one, you are.

"These represent two massive clubs - close from each other - with their own identities.

"In effect, they are the two biggest games of the season so you are conscious that the last thing you want to do is to lose, particularly in your own stadium."

A region reignited

That manager had nothing to fear.

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, Sunderland have been victorious in six of the last seven contests in the top flight.

A former Sunderland manager masterminded half of those victories, having swiftly realised that the fixture was "more significant" than many outsiders thought.

"Beyond family, the club is the most important thing to the people of Sunderland," he said.

"It's so intense that the result of the club can change the mood of the city so imagine the result of the derby? You can sense it.

"I was informed 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."

Sunderland, like Newcastle before them, eventually slipped through the relegation trapdoor in 2017, and spent eight years outside 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 tiny portion of the £40m Newcastle had invested in a single player.

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

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

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 new 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 their own ground.

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 gripping afternoon when these rivals renew hostilities at the Stadium of Light.

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