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

The Newcastle United head coach had just got the 2023 Great North Run under way to rapturous applause in the centre of the city.

But he had failed to anticipate those Black Cats runners who were not so thrilled to see him as they sped 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 inter-city 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 Premier League for almost ten years.

But few 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

Nikos Dabizas also is aware of what can happen when these worlds collide.

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

It shows the Greek wild-eyed, bare chested and among his jubilant team-mates, after netting the winner in front of the traveling support at the Stadium of Light in 2002.

This was a fixture that definitely left its mark on him.

"The key is the passion of the fans," he said. "It's something that goes from generation to generation. This tradition makes this game so special."

So what is at the root of the intense rivalry between two one-club cities less than 15 miles apart?

Well, as far as a Sunderland loyal fan is concerned, it transcends football itself.

"You can go back to the English Civil War with Newcastle supporting the monarchy and Sunderland backing the parliament," he said. "It's rooted in political and economic factors.

"Newcastle receive the funding, Newcastle have the metropolitan status, Newcastle are the ones people always talk about when it comes to the North East. Sunderland 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 meant to the home fans.

"I needed a while afterwards to grasp the significance of it," the player said.

"It eased my life a lot simpler. I was forgiven to make the occasional mistake when playing, simply 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 reputation 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 "added responsibility" of this game because people in the North East "breathe their football".

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

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

"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, particularly in your own stadium."

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

That manager had nothing to fear.

His side ended up hammering 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 meetings in the top flight.

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

"After 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.

"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."

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

So a division divided these rivals when they last met in the domestic cup nearly two years ago.

And the contrast was pronounced.

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.

"It's unlikely the fans really expected, deep down, that we were going to win that game," a former midfielder said. "But now it's changed."

In so many ways.

Only two players are likely to be the only survivors 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 unbeaten on their own ground.

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

So it is all set up to be a gripping 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.