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Eddie Howe found himself on safe ground as he rang the bell.

The Newcastle United manager had just got the 2023 Great North Run started to loud cheers in the centre of the city.

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

"The worst abuse I've ever had," he said 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 significant title 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 few fixtures halt an area quite like the North East derby as former Sunderland manager Peter Reid understands better than most.

"These are football crackers," he said. "Put it this way, there is a touch of extra needle up there."

'The two biggest games of the season'

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

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

It shows the Greek ecstatic, bare chested 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 definitely left its mark on him.

"It's the intensity 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 core of the intense rivalry between two football-mad towns less than 15 miles apart?

Well, as far as a Sunderland season ticket holder is concerned, it transcends football itself.

"You can go back to the English Civil War with Newcastle supporting the monarchy and Sunderland siding with 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. Sunderland are always overshadowed."

But it is far from 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 home fans.

"It took a little bit of time afterwards to realise the importance of it," the player said.

"It made my life a lot easier. I was forgiven to make the occasional 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 recently 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 are.

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

"In effect, they are the two most important games of the season so you are conscious 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 triumphed 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 outsiders thought.

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

"It's so intense that the result of the club can alter the atmosphere of the city so consider the result of the derby? You can feel 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 relegation trapdoor in 2017, and spent eight years away from the top flight.

So a division separated these rivals when they last met in the domestic 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 spent on 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 bold side have competed evenly against some the best teams in the top flight.

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

Such an impressive 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 relevant again with elite fixtures again," a former player added.