The Bereznikers

SSMS (SQL Server Management Studio) does not use any kind of wizardry as one might think. It creates a new table, moves the data, drops the original table and renames the new table to the original name.

The design tool in SSMS can generate a script for any changes you have made.
This option is available via "Generate Change Script" in the "Table Designer" menu or via right-clicking the table editor.